Renin-Guided Therapy
The 2025 Endocrine Society guideline supports up-titrating MRAs when blood pressure is uncontrolled and renin remains suppressed, but the evidence certainty is very low. The guideline does not resolve whether to increase MRAs when renin is…
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The 2025 Endocrine Society guideline supports up-titrating MRAs when blood pressure is uncontrolled and renin remains suppressed, but the evidence certainty is very low. The guideline does not resolve whether to increase MRAs when renin is suppressed but blood pressure is already controlled on MRA monotherapy. RETAME-PA tests whether proactive physician-led renin-guided titration can drive higher biochemical normalisation than traditional markers or patient characteristics. MRA up-titration in the renin-guided arm stops if treatment is not tolerated or potassium exceeds 4.8 mmol/L.