Wcn26-5268 Effect of Patiromer on Serum Potassium and Hospitalization Outcomes in Hemodialysis Patients With or Without Congestive Heart Failure: A Retrospective Cohort Analysis

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hemodialysis with or without congestive heart failure. Intervention: Patiromer vs. Pre-patiromer period. Primary outcome: All-cause hospitalization rate (per patient-year) (p=0.004).

Meijiao Zhou; Linda Ficociello; Maria Gil-Mir; Hans-Juergen Arens; Despina Ruessmann; Michael S. Anger

doi:10.1016/j.ekir.2026.103832

March 25, 2026Kidney International ReportsOpen Access

Wcn26-5268 Effect of Patiromer on Serum Potassium and Hospitalization Outcomes in Hemodialysis Patients With or Without Congestive Heart Failure: A Retrospective Cohort Analysis

View Full Paper

Ask AI

Bookmark

Share

Key result

Patiromer initiation in hemodialysis patients was associated with a significant decrease in the overall all-cause hospitalization rate from 1.77 to 1.68 per patient-year.

Why the study?

Limited real-world data exist on the safety of patiromer in hemodialysis patients, especially those with congestive heart failure, regarding fluid overload and hospitalization outcomes.

Does patiromer reduce hospitalizations and serum potassium in hemodialysis patients with or without congestive heart failure?

Key Points

To evaluate serum potassium levels and hospitalization outcomes before and after initiating patiromer in hemodialysis patients with and without congestive heart failure, focusing on safety signals related to fluid overload.
Retrospective cohort analysis of hemodialysis patients in U.S. kidney care clinics who initiated patiromer between January 1, 2016, and December 31, 2022, after receiving thrice-weekly hemodialysis for >90 days.
Hospitalization rates were assessed across 3 months pre-patiromer and up to 12 months post-patiromer using Poisson regression, stratified by baseline congestive heart failure status (including n=8635 non-heart-failure patients).
All-cause hospitalization decreased from 1.77 to 1.68 per patient-year (p=0.004), hyperkalemia-related hospitalizations decreased by 43% from 0.35 to 0.20 per patient-year (p<0.0001), and fluid-overload hospitalizations decreased from 0.16 to 0.14 per patient-year (p=0.006).
Among patients with congestive heart failure, heart failure-related hospitalizations declined from 0.15 to 0.09 per patient-year (p=0.0005), while fluid-overload hospitalizations remained comparable (0.22 to 0.20 per patient-year; p=0.34).
Serum potassium decreased steadily from baseline to the final follow-up quarter in patients with congestive heart failure (5.55 to 5.15 mEq/L) and without congestive heart failure (5.61 to 5.22 mEq/L).

Study Design

Type

Cohort

Multicenter

Yes

Structured PICO

Does patiromer reduce hospitalizations and serum potassium in hemodialysis patients with or without congestive heart failure?

P

Population

Adult hemodialysis patients with or without congestive heart failure who newly initiated patiromer, evaluated before and up to 12 months after initiation.

E

Exposure

Patiromer initiation

C

Comparator

Pre-patiromer period (3 months prior to initiation)

O

Outcome

Hospitalization rates (all-cause, hyperkalemia-related, fluid-overload, and CHF-related) and serum potassium levels assessed up to 12 months post-initiationhard clinical

Main Result

Absolute Event Rate: 1.68% vs 1.77%

p-value: p=0.004

In hemodialysis patients, patiromer initiation is associated with reduced all-cause and hyperkalemia-related hospitalizations, without increasing the risk of fluid overload or CHF-related admissions.

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

May support consideration to lower hospitalizations in hemodialysis; leaves open randomized confirmation in patients with or without heart failure.

Abstract

Some potassium-binding agents have been associated with increased risk of fluid overload and edema, particularly in patients with congestive heart failure (CHF) or those on sodium-restricted diets. Patiromer (PAT) is a non-absorbed, sodium-free potassium binder used to manage hyperkalemia in patients receiving hemodialysis (HD). While its efficacy is well established, limited real-world data exist on its safety, especially in vulnerable populations such as those with CHF. This retrospective cohort study evaluated serum potassium (sK) levels and hospitalization outcomes before and after PAT initiation in HD patients with and without CHF, focusing on safety signals related to fluid overload and CHF risk.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Zhou et al. (2026) conducted a cohort in Hemodialysis with or without congestive heart failure. Patiromer vs. Pre-patiromer period was evaluated on All-cause hospitalization rate (per patient-year) (p=0.004). Patiromer initiation in hemodialysis patients was associated with a significant decrease in the overall all-cause hospitalization rate from 1.77 to 1.68 per patient-year.

synapsesocial.com/papers/6a025c6fedf6f48138594634 https://doi.org/10.1016/j.ekir.2026.103832

View Full Paper

Ask AI

Bookmark

Share

Wcn26-5268 Effect of Patiromer on Serum Potassium and Hospitalization Outcomes in Hemodialysis Patients With or Without Congestive Heart Failure: A Retrospective Cohort Analysis

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Wcn26-5268 Effect of Patiromer on Serum Potassium and Hospitalization Outcomes in Hemodialysis Patients With or Without Congestive Heart Failure: A Retrospective Cohort Analysis

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading