Key result
Potassium binders such as Patiromer and sodium zirconium cyclosilicate may enable RAASi maintenance and shift the paradigm of hyperkalaemia treatment in CKD patients, pending prospective trials.
Why the study?
Hyperkalaemia frequently limits the use of guideline-directed RAASi in CKD patients, and new potassium binders may enable both potassium control and RAASi maintenance.
Do potassium binders (patiromer, sodium zirconium cyclosilicate) enable RAASi maintenance and improve cardiovascular and renal outcomes in CKD patients with hyperkalaemia?
Do potassium binders (patiromer, sodium zirconium cyclosilicate) enable RAASi maintenance and improve cardiovascular and renal outcomes in CKD patients with hyperkalaemia?
New potassium binders like patiromer and sodium zirconium cyclosilicate may allow for the maintenance of cardioprotective RAAS inhibitors in CKD patients prone to hyperkalaemia, though prospective outcome trials are needed.
Supports RAASi maintenance with potassium binders in CKD hyperkalaemia; hypothesis-generating pending prospective trials.
Chronic kidney disease (CKD) patients and more so CKD patients treated with renin-angiotensin-aldosterone system inhibitors (RAASi) are prone to experience hyperkalaemia, a condition associated with an increased risk of death. This represents a true dilemma in daily practice since RAASi are the cornerstones of nephroprotective and cardioprotective strategies in CKD patients, as well as in hypertensive patients with or without CKD. The recent availability in the USA and EU of the potassium-binding resin Patiromer, together with sodium zirconium cyclosilicate (SZC), which was more recently approved in the EU and the US, may lead to a paradigm shift both in the treatment of hyperkalaemia and in enabling RAASi maintenance. Whether potassium normalization, potentially combined with a RAASi maintenance strategy, may translate into improved cardiovascular and renal outcomes needs be tested prospectively.
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Patrick Rossignol (2019) conducted a review in Hyperkalaemia in Chronic Kidney Disease. Potassium binders (Patiromer and sodium zirconium cyclosilicate) was evaluated. Potassium binders such as Patiromer and sodium zirconium cyclosilicate may enable RAASi maintenance and shift the paradigm of hyperkalaemia treatment in CKD patients, pending prospective trials.
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