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Patients with a creatinine clearance (a measure of kidney function) of less than 20 mL/min should be cautious about their potassium intake and the use of certain medications (like diuretics that spare potassium, ACE inhibitors, blockers of angiotensin receptors, beta-blockers, and nonsteroidal anti-inflammatory drugs)

Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association

This leads to increased membrane permeability, degraded membrane integrity, inactivated enzymes and structural damage of the DNA