Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.