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Abstract Renin-angiotensin-aldosterone inhibitors (RAASi) improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF), but their use is often limited by hyperkalaemia in chronic kidney disease (CKD) patients. This double-blind, placebo-controlled, randomised trial evaluated whether sodium zirconium cyclosilicate (SZC) enables RAASi up-titration in HFrEF patients with CKD stages 3–5 and serum potassium of 5.0–5.5 mmol/L over 14 weeks.
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