Long-term potassium binder use might decrease the risk for adverse outcomes in patients with recurrent hyperkalemia, investigators reported at the American Society of Nephrology’s Kidney Week 2022 meeting.

In a 2008-2018 Japanese hospital-based claim database, 4321 patients experienced recurrent hyperkalemia and were newly prescribed potassium binders. Of the cohort, 80.9% had hypertension, 69.8% had chronic kidney disease (CKD), 56.6% had diabetes, and 44.1% had heart failure. Two-thirds of patients were taking a renin-angiotensin-aldosterone-system (RAAS) inhibitor.

The potassium binder medication possession ratio (MPR) was 80% or higher for 3328 patients and less than 80% for 993 patients. The low and high MPR groups had comparable serum potassium levels at 6 months (least square mean 4.65 vs 4.63 mEq/L) and 12 months (4.67 vs 4.64), Eiichiro Kanda, MD, of Kawasaki Medical School in Kurashiki, Japan, reported for his team.

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Potassium binder discontinuation occurred rapidly within 250 days in the MPR less than 80% group. The low MPR group had a 1.7-fold risk for hyperkalemia recurrence compared with the high MPR group, Dr Kanda reported. The low MPR group also had significant 1.4- and 1.2-fold increased risks of decline in estimated glomerular filtration rate and introduction of renal replacement therapy, respectively, and a significant 1.4-fold increased risk of hospitalization.

“These results suggest that chronic and continuous treatment with [potassium binders] might be beneficial for better clinical outcomes in patients with hyperkalemia,” Dr Kanda concluded.

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


Kanda E, Kikuchi T, Morita N, Yajima T. Impact of chronic potassium binder treatment on clinical outcome in patients with hyperkalemia: A nationwide hospital-based cohort study. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Poster FR-PO549.