Patiromer monotherapy may be effective for acute, non-life-threatening hyperkalemia, investigators reported at Kidney Week 2022, the annual meeting of the American Society of Nephrology.

Use of patiromer for chronic hyperkalemia is well established, but the drug’s effectiveness for acute non-life-threatening hyperkalemia, particularly in patients with impaired renal function, is not well described, according to investigators.

Using 2018-2021 electronic health records, investigators identified 2048 patients with hyperkalemia treated with a one-time 8.4 g dose of patiromer. Patients with pending dialysis orders or concomitant hyperkalemia therapy within 3 hours of patiromer administration were excluded.

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Serum potassium significantly decreased by a mean 0.4 mEq/L at 0-6 hours, 0.4 mEq/L at 6-12 hours, and 0.4 mEq/L at 12-24 hours, compared with baseline, Pavel Goriacko, PharmD, MPH, of Montefiore Health System in Bronx, New York, reported. Within 24 hours, it decreased by a median 0.50 mEq/dL in patients without renal impairment and 0.37 mEq/dL in patients with renal impairment (estimated glomerular filtration rate less than 60 mL/min/1.73 m2).

Incidence rates of hypokalemia and hypomagnesemia were low, Goriacko reported. Hypokalemia within 48 hours occurred in 0.4% and 0.1% of patients with and without renal impairment. Hypomagnesemia within 48 hours occurred in 1.9% and 2.0%, respectively. 

“These findings suggest clinical utility of patiromer for episodic hyperkalemia in hospitalized patients with and without renal impairment,” the investigators concluded in a study abstract.

Disclosure: This research was supported by Vifor. Please see the original reference for a full list of disclosures.


Evaluation of patiromer monotherapy for acute hyperkalemia in an institutional setting based on presence of renal impairment. Presented at: Kidney Week 2022, November 3-6, Orlando, Florida. Poster FR-PO551.