Clinical review reveals sodium zirconium cyclosilicate achieves potassium control in cardiorenal disease, suggesting sustained renin-angiotensin-aldosterone system inhibitor therapy.
Hyperkalemia is a common and potentially life-threatening complication in patients with chronic kidney disease and heart failure. It also represents a major barrier to the optimal use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are central to improving cardiorenal outcomes. Contemporary guidance, including the 2025 Korean Society of Nephrology Practical Recommendations for the Management of Hypertensive Kidney Disease, emphasizes the maintenance of normokalemia as a key strategy for enabling continuation and optimization of RAASi therapy. Sodium zirconium cyclosilicate (SZC) supports this therapeutic paradigm by enabling rapid potassium reduction and sustained potassium control. This review repositions hyperkalemia as a modifiable barrier to guideline-directed therapy and summarizes the pharmacology, clinical evidence, and practical considerations related to SZC use in patients at high cardiorenal risk.
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Juarez et al. (2026) studied this question.
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