Sodium zirconium cyclosilicate for the management of chronic hyperkalemia in kidney disease, a novel agent

Rastogi, Anjay; Hanna, Ramy M; Mkrttchyan, Anita; Khalid, Maham; Yaqoob, Sinan; Dhawan, Puneet; Nobakht, Niloofar; Kamgar, Mohammad; Goshtaseb, Ray; Sarmosyan, Kristine; Gnarini, Mariarosaria; Wassef, Olivia; Lerma, Edgar V.

doi:10.1080/17512433.2021.1932460

Cited by 3 publications

(2 citation statements)

References 51 publications

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“…However, at the time of this study, the PBs available in Japan were SPS and CPS. Further studies including the newer-generation PB, SZC (Lokelma ® , AstraZeneca), may show a greater difference in clinical outcomes by maintaining, initiating, or up-titrating RAASi ( Linder et al, 2016 ; Imamura et al, 2021 ; Rastogi et al, 2021 ; Swanson et al, 2021 ; Williams et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of chronic potassium binder treatment on the clinical outcomes in patients with hyperkalemia: Results of a nationwide hospital-based cohort study

Kanda

Morita²,

Yajima³

2023

Front. Physiol.

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Introduction: Hyperkalemia (HK) is a common disorder in patients with heart failure or chronic kidney disease, and potassium binders (PBs) are recommended to control serum potassium (S-K) levels. Although HK is often a chronic condition, short-term and intermittent PBs treatment has been largely applied to control S-K levels, and little is known about the impact of long-term and chronic PBs treatment on clinical outcomes.Method: This retrospective cohort study was conducted using a Japanese claims database (April 2008–September 2018). HK was defined as at least two S-K ≥5.1 mmol/L within a 12-month(M) interval. The index date was defined as the initial PB prescription date, and the S-K values were examined at 3M, 6M, and 12M after the index. The medication possession ratio (MPR) was used to evaluate the length of the prescribed period of PB, as prescription refill was not allowed in Japan. Clinical outcomes were analyzed by comparing MPR <80% to MPR ≥80% using Cox proportional hazards regression.Results: We found 4,321 patients with HK and were on initial PB treatments, and 993 and 3,328 patients were categorized in the MPR <80% and MPR ≥80% groups, respectively. The mean prescription days ±SD in the MPR <80% and MPR ≥80% groups were 114.7 ± 9.1 and 1151.2 ± 22.5, respectively. S-K value with adjustment by covariates in MPR <80% and MPR ≥80% groups were 5.62 (95% CI: 5.57–5.68) and 5.72 (95% CI: 5.68–5.76) at index followed by 4.65 (95% CI: 4.58–4.71) and 4.57 (95% CI: 4.51–4.62) at 3M, respectively. The hazard ratios of incidence rates in hospitalization was 1.41 (p < 0.001), introduction of renal replacement therapy was 1.25 (p < 0.003), recurrent HK was 1.67 (p < 0.001), and decreased eGFR was 1.41 (p < 0.001), respectively.Conclusion: These results indicate a higher risk of adverse outcomes when PBs were not prescribed chronically, whereas S-K levels were similarly controlled. Chronic control with continued PBs rather than temporary treatment may be associated with the reduction of adverse clinical outcomes in patients with HK.

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Section: Discussionmentioning

confidence: 99%

Impact of chronic potassium binder treatment on the clinical outcomes in patients with hyperkalemia: Results of a nationwide hospital-based cohort study

Kanda

Morita²,

Yajima³

2023

Front. Physiol.

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“…68 Newer potassium exchangers, like patiromer and sodium zirconium cyclosilicate, allow patients with hyperkalemia or risk factors for hyperkalemia to adopt ''a more liberal and healthy diet'' with a focus on plant foods. 69 Although it is not necessary for all patients consuming plant-based diets to be on a potassium exchanger, they may be used judiciously in those who need it while balancing their risks and costs.…”

Section: Plant Foods and Hyperkalemia In Kidney Diseasementioning

confidence: 99%

Taking the Kale out of Hyperkalemia: Plant Foods and Serum Potassium in Patients With Kidney Disease

Babich

Kalantar‐Zadeh

Joshi

2022

Journal of Renal Nutrition

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Renal Nutrition—Where It Has Been and Where It Is Going

Kopple

Ekramzadeh

2022

Kidney and Dialysis

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This paper is a synopsis of an invited lecture entitled, The Future of Renal Nutrition, that was presented at the Japanese Society of Dialysis Therapy, July 2022. The purpose of this presentation is to suggest some of the advances in the field of renal nutrition that the authors think are likely to occur during the next several years. There will be continued development of methods for precisely diagnosing and classifying protein-energy wasting and developing methods to treat this disorder. Why weight loss commonly occurs when the GFR decreases to about 30–35 mL/min/1.73 m2 and why substantial weight loss (>5%/year) is associated with increased mortality will be investigated. Clinical consequences of the interactions between gut microbiota, nutrient intake and other environmental influences will continue to be examined. The clinical value of diets high in fruits and vegetables or other plants for chronic kidney disease (CKD) patients will continue to be studied. Our knowledge of how different diets and medicines affect intestinal absorption, metabolism and excretion of nutrients will expand. Precision medicine will be extended to precision nutrition. There will be more focus on the effects of nutritional disorders and dietary treatment on the emotional status and quality of life of people with kidney disease and their families. Nutritional centers that provide centralized nutritional assessment and dietary counselling for CKD patients may develop in more urban centers. More clinical trials will be conducted to test whether nutritional management improves clinical outcomes in people with kidney disease. It is hoped that the foregoing comments will encourage more research on these topics.

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Sodium zirconium cyclosilicate for the management of chronic hyperkalemia in kidney disease, a novel agent

Cited by 3 publications

References 51 publications

Impact of chronic potassium binder treatment on the clinical outcomes in patients with hyperkalemia: Results of a nationwide hospital-based cohort study

Impact of chronic potassium binder treatment on the clinical outcomes in patients with hyperkalemia: Results of a nationwide hospital-based cohort study

Taking the Kale out of Hyperkalemia: Plant Foods and Serum Potassium in Patients With Kidney Disease

Renal Nutrition—Where It Has Been and Where It Is Going

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