Contemporary potassium binders such as sodium zirconium cyclosilicate and patiromer are efficacious and well-tolerated, facilitating the maintenance of goal-directed medical therapy in patients with chronic hyperkalemia.
Contemporary management of hyperkalemia emphasizes the use of novel potassium binders and challenges strict dietary restrictions to enable the continuation of life-saving RAAS inhibitor therapy in high-risk patients.
It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated. In this review, we will briefly discuss the definition, causes, epidemiology and consequences of hyperkalemia. The majority of the review will be focused on management of hyperkalemia in the acute and chronic setting, emphasizing contemporary approaches and evolving data on the relevance of dietary restriction and the use of novel potassium binders.
Larivée et al. (Mon,) conducted a review in Hyperkalemia. Hyperkalemia management strategies (including novel potassium binders) was evaluated. Contemporary potassium binders such as sodium zirconium cyclosilicate and patiromer are efficacious and well-tolerated, facilitating the maintenance of goal-directed medical therapy in patients with chronic hyperkalemia.