New potassium binders (patiromer and sodium zirconium cyclosilicate) provide a practical option to manage hyperkalaemia in heart failure and chronic kidney disease, enabling RAAS inhibitor use.
How can new potassium binders be practically used to manage hyperkalaemia and allow RAAS inhibitor uptitration in patients with heart failure and CKD?
New potassium binders offer a practical tool to manage hyperkalaemia and facilitate optimal RAAS inhibitor therapy in patients with heart failure and CKD.
Hyperkalaemia is a life-threatening condition leading to significant morbidity and mortality. It is common in heart failure and in chronic kidney disease (CKD) patients due to the diseases themselves, which often coexist, the high co-presence of diabetes, the fluctuations in renal function, and the use of some drugs i.e. renin-angiotensin-aldosterone system (RAAS) inhibitors. Hyperkalaemia limits their administration or uptitration, thus impacting on mortality. New K + binders, namely patiromer and sodium zirconium cyclosilicate (ZS-9), are an intriguing option to manage hyperkalaemia in heart failure and/or CKD patients, both to reduce its fatal effects and to let clinicians uptitrate RAAS inhibition. Even if their real impact on strong outcomes is still to be determined, we hereby provide a practical approach to favour their use in routine clinical practice in order to gain the correct confidence and provide an additive tool to heart failure and CKD patients' wellbeing. New trials are welcome to fill the gap in knowledge.
Senni et al. (Wed,) conducted a review in Heart failure and chronic kidney disease with hyperkalaemia. New potassium binders (patiromer and sodium zirconium cyclosilicate) was evaluated. New potassium binders (patiromer and sodium zirconium cyclosilicate) provide a practical option to manage hyperkalaemia in heart failure and chronic kidney disease, enabling RAAS inhibitor use.