I've already asked a few - as yet officially unanswered - questions about RSA-KEM with regards to the input secret encrypted using the public key here and (less on topic for this question) here.
CodesInChaos already commented in the first question linked to. It seems logical that having the most significant bit set to zero during generation of the random value $z$ to not impact security all that much.
Still, the use of random number generators for large amounts of data can be a draw back of the mode of operation, especially when they are required to generate 4096 bits of randomness for a single RSA operation. This could be an issue if said random number generator is slow or if insufficient entropy is available to the random number generator.
My related questions are:
Can we reduce the amount of input keying material to the KDF further without reducing the security of the RSA operation? If yes, by how much?
If yes, is there a good distribution of random bits required (half to the left, half to the right?)
If no, could we use a one-way primitive such as a XOF or indeed MGF-1 after retrieving the required number of bits for secure key derivation, and feed that to RSA-KEM?
Or should I just run away and use RSA OAEP instead if I run into situations where a fast DRBG is not available?