Furthermore, guidelines state that MRA should be discontinued in patients with persistent hyperkalemia only if it is not possible to manage it with other measures.3, –5,22 The risk of hyperkalemia may be relatively lower with the newer nonsteroidal MRA finerenone, but its use still warrants careful monitoring of K+ levels.4,33,34 Sodium-glucose cotransporter 2 inhibitors, which are now the standard of care in both CKD and HF,3, –5 may reduce the risk of severe hyperkalemia,35, –37 although their role in hyperkalemia management in clinical practice is still to be determined.38 This evidence concerns the gene SLC5A2 and hydrops fetalis.