The Journal of family practice
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► recent history of hand-foot-mouth disease ► discolored fingernails and toenails lifting from the proximal end.
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Probably. Renin-angiotensin-aldosterone system (RAAS) blockade therapy should be continued in most patients with advanced renal disease and comorbid conditions; however, individualized treatment is warranted as data on the benefits and harms in all-cause mortality, cardiovascular mortality, and risk for renal replacement therapy are inconclusive (strength of recommendation [SOR]: B, based on observational studies, systematic reviews, and meta-analyses of randomized controlled trials [RCTs]). Certain patient populations, such as patients with diabetes or those with cardiovascular risk or history, may benefit most from continued RAAS blockade therapy (SOR: A, based on systematic reviews and meta-analyses of RCTs).
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A systematic review and meta-analysis found that these combinations were superior to monotherapy and had comparable tolerability.