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Optimizing RAAS inhibition is an important therapeutic goal, particularly in chronic kidney disease. Different strategies have been investigated to achieve this goal, including inhibiting the pathway at multiple steps and using maximum or even supramaximal doses. Hyperkalemia is one of the most significant barriers to all of the strategies mentioned above. Up until the recent past, there have been limited therapeutic options available for the prevention and treatment of hyperkalemia in the long term. New promising agents to treat hyperkalemia in outpatient settings, namely, patiromer and sodium zirconium, may provide a solution. This article will review the benefits and risks of RAAS inhibitors, strategies to optimize their use, and the new hyperkalemia treatments that can lower the risk associated with RAAS inhibiting therapies.

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Introduction:Headache is a common complaint in children, and it has a significant effect on their daily living activities. Having a definite diagnosis for the cause of the headache is very important for its appropriate management. Case Presentation: We report a 12-year-old boy complaining of chronic headache, with a positive family history of migraine. The only abnormal finding in his general and neurological examinations, and CT scan evaluation of his brain and paranasal sinuses, was a retention cyst in his sphenoid sinus. The child's symptoms did not improve after receiving migraine medications or treatment for sinusitis. Further investigations revealed positive serological results for brucellosis infection. His symptoms were relieved, and imaging evidence of sinus involvement disappeared after brucellosis treatment. The child remained headache free in later follow-ups. Discussion: In evaluating the cause of children's headaches, brucellosis must be considered in differential diagnosis.