ACE and Hyperkalemia: Severe hyperkalemia often results from CKD or from medications that impair renal potassium excretion, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), mineralocorticoid receptor antagonists (MRAs) such as spironolactone and eplerenone, potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), and potassium supplements.