Safety and efficacy of sodium zirconium cyclosilicate for the management of acute and chronic hyperkalemia in children with chronic kidney disease 4–5 and on dialysis

Khandelwal, Priyanka; Shah, Sarit; McAlister, Louise; Cleghorn, Shelley; King, Lillian; Shroff, Rukshana

doi:10.1007/s00467-023-06176-6

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Its universality is evident in real-world studies across different ethnic groups, where patients receiving SZC for the treatment or prevention of hyperkalemia experienced a significant reduction in mortality rates ( Qu et al, 2023 ; Onogi et al, 2024 ). SZC not only shows significant efficacy in the treatment of hyperkalemia in adults but is also safe and effective for acute and chronic hyperkalemia in children ( Khandelwal et al, 2024 ). Additionally, studies indicate that in patients with heart failure, SZC can help maintain normal potassium levels, allowing the continued use of medications that might cause hyperkalemia, such as renin-angiotensin-aldosterone system (RAAS) blockers ( Anker et al, 2015 ; Butler et al, 2019 ; Abrignani et al, 2024 ; Kimura et al, 2024 ).…”

Section: Introductionmentioning

confidence: 99%

Advancing crush syndrome management: the potent role of Sodium zirconium cyclosilicate in early hyperkalemia intervention and survival enhancement in a rat model

Li,

Zhang,

Chen

et al. 2024

Front. Pharmacol.

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Background: Crush Syndrome (CS), a severe trauma resulting from prolonged muscle compression, is commonly seen in large-scale disasters such as earthquakes. It not only causes localized tissue damage but also triggers electrolyte imbalances, particularly hyperkalemia, increasing the risk of early mortality. This study aims to assess the early intervention effects of Sodium Zirconium Cyclosilicate (SZC) on hyperkalemia in rat CS model.Methods: A rat CS model was established using a self-developed multi-channel intelligent small-animal crush injury platform. Rats in the experimental groups were treated with varying doses of SZC before compression and immediately post-decompression. The efficacy of SZC was evaluated by continuous monitoring of blood potassium levels and survival rates. Serum creatinine (Cre) and blood urea nitrogen (BUN) levels were analyzed, and renal damage was assessed through histopathological examination.Results: SZC treatment significantly reduced blood potassium levels and improved survival rates in rats. Compared to the placebo group, the SZC-treated rats showed a significant decrease in blood potassium levels at 6 and 12 h post-decompression, maintaining lower levels at 24 h. Biochemical analysis indicated no significant impact of SZC on renal function, with no notable differences in Cre and BUN levels between groups. Histopathological findings revealed similar levels of renal damage in both groups.Conclusion: SZC demonstrates significant early intervention effects on hyperkalemia in a rat model of crush injury, effectively improving survival rates without adverse effects on renal function. These results provide a new strategic direction for the clinical treatment of Crush Syndrome and lay the foundation for future clinical applications.

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Section: Introductionmentioning

confidence: 99%

Advancing crush syndrome management: the potent role of Sodium zirconium cyclosilicate in early hyperkalemia intervention and survival enhancement in a rat model

Li,

Zhang,

Chen

et al. 2024

Front. Pharmacol.

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Nutritional management of the child with chronic kidney disease and on dialysis

Shaw,

Anderson,

Desloovere

et al. 2024

Pediatr Nephrol

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While it is widely accepted that the nutritional management of the infant with chronic kidney disease (CKD) is paramount to achieve normal growth and development, nutritional management is also of importance beyond 1 year of age, particularly in toddlers, to support the delayed infantile stage of growth that may extend to 2–3 years of age. Puberty is also a vulnerable period when nutritional needs are higher to support the expected growth spurt. Inadequate nutritional intake throughout childhood can result in failure to achieve full adult height potential, and there is an increased risk for abnormal neurodevelopment. Conversely, the rising prevalence of overweight and obesity among children with CKD underscores the necessity for effective nutritional strategies to mitigate the risk of metabolic syndrome that is not confined to the post-transplant population. Nutritional management is of primary importance in improving metabolic equilibrium and reducing CKD-related imbalances, particularly as the range of foods eaten by the child widens as they get older (including increased consumption of processed foods), and as CKD progresses. The aim of this review is to integrate the Pediatric Renal Nutrition Taskforce (PRNT) clinical practice recommendations (CPRs) for children (1–18 years) with CKD stages 2–5 and on dialysis (CKD2–5D). We provide a holistic approach to the overall nutritional management of the toddler, child, and young person. Collaboration between physicians and pediatric kidney dietitians is strongly advised to ensure comprehensive and tailored nutritional care for children with CKD, ultimately optimizing their growth and development. Graphical abstract

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