It is challenging for CKD patients to stay on spironolactone therapy because it can increase the risk of hyperkalemia, according to researchers.
Prescription patterns suggest patiromer is used more often for chronic treatment of hyperkalemia and polystyrene sulfonate for episodic treatment.
In a study of hemodialysis patients, only 0.6%, 0.5%, and 0.9% hypokalemia events occurred at 1, 2, and 3 months after initiating patiromer treatment.
In 3 studies, patiromer reduced serum potassium by 0.65 to 1.01 meq/L at 4 weeks.
Serum potassium concentrations outside the normal range were associated with elevated mortality risk in patients with heart failure.
Hyperkalemia management is hindered by the shortage of information about potassium additives in foods, according to the author of new review.
Hyperkalemia vs normokalemia at admission to a cardiac intensive care unit was associated with 44% increased odds of in-hospital mortality, independent of illness severity and renal function.
In a study, the risk for hyperkalemia was 5 times higher with diabetic nephropathy and twice as high with glomerulonephritis than with PKD.
Almost half of incident hyperkalemia events are followed by changes in RAAS inhibitor therapy.
Patients treated with the mineralocorticoid receptor antagonist had a higher frequency of moderate hyperkalemia compared with placebo recipients.