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.
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.