Do you stop ACEi or ARB medications in patients with ESKD who are on hemodialysis and have issues with chronic hyperkalemia?  

I don't. I don't think it contributes much to the hyperkalemia. I usually try to correct the potassium using modifications of the potassium bath, dietary changes and if still high potassium binders.

I try not to, given the beneficial cardiovascular effects, and I add potassium binders and dietary modifications. However, hyperkalemia does increase mortality in ESRD patients, so if the potassium remains high despite these interventions, I will stop the ACEi or ARB. The data are mixed, as far as I...