Tailoring treatment of hyperkalemia

Coutrot, Maxime; Dépret, François; Legrand, Matthieu

doi:10.1093/ndt/gfz220

Cited by 3 publications

(2 citation statements)

References 61 publications

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“…This can be achieved through the limitation of potassium intake and the use of medications that increase potassium elimination via urine or the gastrointestinal tract (GI), such as loop diuretics or cation-exchanging resins, or alternatively, by use of hemodialysis, which can reduce body K + content but usually require more time to act [35].…”

Section: Hyperkalemia: Treatment Strategiesmentioning

confidence: 99%

New Treatment Options for Hyperkalemia in Patients with Chronic Kidney Disease

Esposito

Conti

Falqui

et al. 2020

JCM

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Hyperkalemia may cause life-threatening cardiac and neuromuscular alterations, and it is associated with high mortality rates. Its treatment includes a multifaceted approach, guided by potassium levels and clinical presentation. In general, treatment of hyperkalemia may be directed towards stabilizing cell membrane potential, promoting transcellular potassium shift and lowering total K+ body content. The latter can be obtained by dialysis, or by increasing potassium elimination by urine or the gastrointestinal tract. Until recently, the only therapeutic option for increasing fecal K+ excretion was represented by the cation-exchanging resin sodium polystyrene sulfonate. However, despite its common use, the efficacy of this drug has been poorly studied in controlled studies, and concerns about its safety have been reported. Interestingly, new drugs, namely patiromer and sodium zirconium cyclosilicate, have been developed to treat hyperkalemia by increasing gastrointestinal potassium elimination. These medications have proved their efficacy and safety in large clinical trials, involving subjects at high risk of hyperkalemia, such as patients with heart failure and chronic kidney disease. In this review, we discuss the mechanisms of action and the updated data of patiromer and sodium zirconium cyclosilicate, considering that the availability of these new treatment options offers the possibility of improving the management of both acute and chronic hyperkalemia.

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Section: Hyperkalemia: Treatment Strategiesmentioning

confidence: 99%

New Treatment Options for Hyperkalemia in Patients with Chronic Kidney Disease

Esposito

Conti

Falqui

et al. 2020

JCM

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“…Hyperkalemia is an electrolyte disorder characterized by elevated levels of serum potassium [1]. Symptoms include muscle weakness, paralysis, and cardiac dysfunction (e.g., arrhythmia), which may be life-threatening [2,3].…”

Section: Introductionmentioning

confidence: 99%

Inpatient management and post-discharge outcomes of hyperkalemia

Davis

Israni

et al. 2021

Hospital Practice

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Objectives: Patients with hyperkalemia are commonly treated in the inpatient setting; however, realworld evidence is limited. The purpose of this study was to describe the inpatient management and post-discharge outcomes among patients with hyperkalemia. Methods: Electronic medical record data (2012)(2013)(2014)(2015)(2016)(2017)(2018) were used to analyze US adult patients with an inpatient stay with hyperkalemia (≥1 potassium value >5.0mEq/L). Patient characteristics, treatments, and monitoring six months prior to and during the inpatient stay, and hyperkalemia recurrence and inpatient readmissions post-discharge were summarized and compared among patients with mild (>5.0-5.5mEq/L), moderate (>5.5-6.0), and severe (>6.0) hyperkalemia. Results: Of the 21,793 patients, 69.2% had mild, 19.0% had moderate, and 11.8% had severe hyperkalemia during inpatient care. The most common inpatient treatments were temporizing agents (mild: 28.9%; moderate: 46.0%; severe: 73.0%), diuretics (32.7%; 37.1%; 34.6%), and sodium-polystyrene sulfonate (11.7%; 27.8%; 45.3%). Almost no patients (0.1%) received a potassium binder at discharge. Most patients (86.8%) had their potassium levels return to ≤5.0mEq/L during the inpatient stay. Death during the inpatient stay occurred in 12.3% of mild, 15.5% of moderate, and 19.5% of severe hyperkalemic patients. Within 30 days of discharge, hyperkalemia recurred in 13.3%, 15.4%, and 18.4% of patients with mild, moderate, and severe hyperkalemia, respectively. Additionally, 19.7%, 21.5%, and 19.6% of patients were readmitted to inpatient care within 30 days post-discharge. Conclusion: Among patients with hyperkalemia in the inpatient setting, treatment and normalization of serum potassium levels were common. However, death, readmission, and hyperkalemia recurrence were also fairly common across all cohorts. Future studies examining measures to reduce inpatient death, readmission, and hyperkalemia recurrence among patients with hyperkalemia in inpatient care are warranted.

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Sliding with the sines − fatal hyperkalemia: A case report

Soe¹,

Seto²

2021

WJC

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Tailoring treatment of hyperkalemia

Cited by 3 publications

References 61 publications

New Treatment Options for Hyperkalemia in Patients with Chronic Kidney Disease

New Treatment Options for Hyperkalemia in Patients with Chronic Kidney Disease

Inpatient management and post-discharge outcomes of hyperkalemia

Sliding with the sines − fatal hyperkalemia: A case report

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