Limited data have shown that the addition of an MRA, such as spironolactone, epler- enone, or nerenone, to an ACEi or ARB for renoprotection in patients with diabetes and kidney disease resulted in a reduc- tion of albuminuria but a higher risk of hyperkalemia. Beyond albuminuria, no adequately powered study examining GFR and kidney failure outcomes has been completed with spi- ronolactone or eplerenone.295 However, the recent FIDELIO trial showed kidney and cardiovascular protection by ner- enone despite its modest effect on SBP (2 3 mm Hg lower) and a higher incidence of hyperkalemia-related events.258 Results of the FIGARO cardiovascular trial, which is also testing nerenone on the background of an ACEi or ARB in patients with diabetes and kidney disease, are forthcoming. Research recommendations  The bene ts of dual versus monotherapy on major kidney outcomes in people with CKD without diabetes and severely increased proteinuria (e.g., >2 3 g/d) have not been well studied. Future trials should examine this important sub- group, while curtailing the risks of hyperkalemia and AKI.  Conduct studies examining the addition of endothelin blockers or GLP-1 receptor agonists to concomitant RASi monotherapy for potential kidney bene ts in the advanced CKD (G4 G5) population and the nonproteinuric CKD populations.  In the era of personalized medicine, research should be directed to identify individuals who will bene t or experience harm from these combinations in all CKD populations. chapter 3 www.kidney-international.org Chapter 4: Blood pressure management in kidney transplant recipients (CKD G1T G5T) This chapter makes recommendations for BP management in adult (age $18 years) kidney transplant recipients (CKD G1T G5T). The evidence review for this chapter included an update of a previous Cochrane review296 in addition to a new search of the Cochrane Kidney and Transplant Registry for all RCTs. 