Key result
Novel potassium binders manage chronic hyperkalemia in heart failure, potentially enabling guideline-directed RAAS inhibitor therapy.
Why the study?
Patients with heart failure are at heightened risk for hyperkalemia, especially when treated with renin-angiotensin-aldosterone system inhibitors, and acute hyperkalemia treatments may not be tolerated long term. Recent data on chronic potassium binders such as patiromer and sodium zirconium cyclosilicate have prompted interest in novel management strategies to enable optimal heart failure therapy.
This review highlights how novel potassium binders like patiromer and sodium zirconium cyclosilicate can manage chronic hyperkalemia in heart failure, potentially enabling optimal renin-angiotensin-aldosterone system inhibitor therapy.
Answers are grounded in this paper and cite their sources.
Novel binders may enable RAAS inhibitor optimization in hyperkalemic HF; leaves open impact on hard outcomes.
Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure.
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Sarwar et al. (2016) conducted a review in Hyperkalemia in heart failure. Patiromer and sodium zirconium cyclosilicate was evaluated. Patiromer and sodium zirconium cyclosilicate treat and prevent chronic hyperkalemia in heart failure, potentially enabling renin-angiotensin-aldosterone system inhibitor therapy.
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