Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system

Nilsson, Erik; Gasparini, Alessandro; Ärnlöv, Johan; Xu, Hairong; Henriksson, Karin; Coresh, Josef; Carrero, Juan Jesús

doi:10.1016/j.ijcard.2017.07.035

Cited by 143 publications

(137 citation statements)

References 48 publications

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“…Esaxerenone up to a dosage of 2.5 mg/d showed a similar risk of a clinically significant increase in serum K + compared with placebo. It has been reported that the chances of detecting hyperkalemia increase with the number of measurements (32). Nevertheless, serum K + levels were measured 11 times in this study, and similar incidences of hyperkalemia were observed in the placebo and esaxerenone groups of up to 2.5 mg/d.…”

Section: Baseline Daymentioning

confidence: 46%

Efficacy and Safety of Esaxerenone (CS-3150) for the Treatment of Type 2 Diabetes with Microalbuminuria

Ito

Shikata

Nangaku

et al. 2019

CJASN

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Background and objectives The progression of kidney disease in some patients with type 2 diabetes mellitus may not be adequately suppressed by renin-angiotensin system inhibitors. Esaxerenone (CS-3150) is a nonsteroidal mineralocorticoid receptor blocker that has shown kidney protective effects in preclinical studies, and it is a potential add-on therapy to treat diabetic kidney disease. This phase 2 study evaluated the efficacy and safety of esaxerenone in Japanese patients with type 2 diabetes mellitus and microalbuminuria.Design, setting, participants, & measurements This multicenter, randomized, double-blind, placebo-controlled trial enrolled 365 hypertensive or normotensive patients with type 2 diabetes mellitus and microalbuminuria (urinary albumin-to-creatinine ratio $45 to ,300 mg/g creatinine) treated with renin-angiotensin system inhibitor who had eGFR$30 ml/min per 1.73 m 2 . Participants were randomized to receive 0.625, 1.25, 2.5, or 5 mg/d esaxerenone or placebo for 12 weeks. The primary end point was the change in urinary albumin-tocreatinine ratio from baseline to week 12 (with last observation carried forward).Results Esaxerenone treatment at 1.25, 2.5, and 5 mg/d significantly reduced urinary albumin-to-creatinine ratio by the end of treatment (38%, 50%, and 56%, respectively) compared with placebo (7%; all P,0.001). The urinary albumin-to-creatinine ratio remission rate (defined as urinary albumin-to-creatinine ratio ,30 mg/g creatinine at the end of treatment and $30% decrease from baseline) was 21% in the 2.5-and 5-mg/d groups versus 3% for placebo (both P,0.05). Adverse events occurred slightly more frequently with esaxerenone versus placebo, but the frequencies of drug-related adverse events and discontinuation rates were similar in the placebo and the 0.625-, 1.25-, and 2.5-mg/d groups. Drug-related adverse events and treatment discontinuations were marginally higher in the 5-mg/d group. The most common drug-related adverse event was hyperkalemia, which was dose proportional.Conclusions Adding esaxerenone at 1.25, 2.5, and 5 mg/d for 12 weeks to an ongoing renin-angiotensin system inhibitor significantly reduces urinary albumin-to-creatinine ratio in patients with type 2 diabetes mellitus and microalbuminuria.

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Section: Baseline Daymentioning

confidence: 46%

Efficacy and Safety of Esaxerenone (CS-3150) for the Treatment of Type 2 Diabetes with Microalbuminuria

Ito

Shikata

Nangaku

et al. 2019

CJASN

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“…K + was assessed by potentiometric titration, with laboratory reference ranges of 3.6–4.6 mmol/L for serum K + and 3.5–4.4 mmol/L for plasma K + . Plasma K + was the most frequent form of measurement, accounting for 91% of all measurements in the system . Values >10 mmol/L were considered implausible and discarded.…”

Section: Methodsmentioning

confidence: 99%

Incidence, predictors and clinical management of hyperkalaemia in new users of mineralocorticoid receptor antagonists

Trevisan

Deco

et al. 2018

European J of Heart Fail

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“…Similarly, in the healthcare system of Stockholm region some centres measure potassium in serum while others measure potassium in plasma, and some centres have changed from one to the other in recent years . Having both values appear in clinical and research databases may impact research in this area and has implications for clinical care.…”

Section: Introductionmentioning

confidence: 99%

Clinical and research implications of serum versus plasma potassium measurements

Cooper

Savarese

Carrero

et al. 2018

European J of Heart Fail

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Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system

Abstract: Hypo- and hyperkalemia are common in healthcare. Optimal RAASi and diuretics use and careful potassium monitoring in the presence of certain comorbidities, especially lower eGFR, is advocated.

Cited by 143 publications

References 48 publications

Efficacy and Safety of Esaxerenone (CS-3150) for the Treatment of Type 2 Diabetes with Microalbuminuria

Efficacy and Safety of Esaxerenone (CS-3150) for the Treatment of Type 2 Diabetes with Microalbuminuria

Incidence, predictors and clinical management of hyperkalaemia in new users of mineralocorticoid receptor antagonists

Clinical and research implications of serum versus plasma potassium measurements

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