Real-world management of chronic and postprandial hyperkalemia in CKD patients treated with patiromer : a single-center retrospective study
© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology..
INTRODUCTION: Hyperkalemia, one of the most important electrolyte abnormalities of chronic kidney disease (CKD), often limits the use of renin-angiotensin-aldosterone system inhibitors and can increase in the postprandial period. In this study we report a real-world experience with the new non-adsorbed potassium binder patiromer in stage 3b-4 CKD patients. Moreover, we performed a cross-sectional analysis to evaluate, for the first time, the efficacy of patiromer in the control of postprandial potassium concentrations.
METHODS: We retrospectively collected data of 40 patients at the time of patiromer initiation (T0), and after 2 (T2), 6 (T6) and 12 (T12) months of treatment. For cross sectional analysis, a blood sample was collected 2 h after the main meal for the evaluation of postprandial potassium concentrations.
RESULTS: Eighty-two point five percent of patients (33/40) reached normal potassium concentrations at T2. Serum potassium significantly decreased at T2 compared to T0 (5.13 ± 0.48 vs 5.77 ± 0.41 mmol/L, respectively; p < 0.001) and the reduction remained significant during the follow-up (5.06 ± 0.36 at T6 and 5.77 ± 0.41 at T12; p < 0.001 vs T0). Renin-angiotensin-aldosterone system inhibitors were continued by 93% of patients (27/29). Adverse events were reported in 27.5% of patients and were all mild-to-moderate. Postprandial potassium concentrations did not significantly change compared to fasting state potassium measured at T12 (4.53 ± 0.33 vs 5.06 ± 0.36 mmol/L; p = 0.15).
CONCLUSIONS: In a real-world setting of advanced CKD patients, patiromer is a useful treatment for hyperkalemia, since it significantly reduces serum potassium levels over the long term and is able to maintain potassium concentrations in the normal range even in the post-prandial period.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of nephrology - (2024) vom: 06. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Riccio, Eleonora [VerfasserIn] |
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| Links: |
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| Themen: |
ACEi |
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| Anmerkungen: |
Date Revised 06.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s40620-024-01897-9 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368088138 |
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| 100 | 1 | |a Riccio, Eleonora |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Real-world management of chronic and postprandial hyperkalemia in CKD patients treated with patiromer |b a single-center retrospective study |
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| 520 | |a © 2024. The Author(s) under exclusive licence to Italian Society of Nephrology. | ||
| 520 | |a INTRODUCTION: Hyperkalemia, one of the most important electrolyte abnormalities of chronic kidney disease (CKD), often limits the use of renin-angiotensin-aldosterone system inhibitors and can increase in the postprandial period. In this study we report a real-world experience with the new non-adsorbed potassium binder patiromer in stage 3b-4 CKD patients. Moreover, we performed a cross-sectional analysis to evaluate, for the first time, the efficacy of patiromer in the control of postprandial potassium concentrations | ||
| 520 | |a METHODS: We retrospectively collected data of 40 patients at the time of patiromer initiation (T0), and after 2 (T2), 6 (T6) and 12 (T12) months of treatment. For cross sectional analysis, a blood sample was collected 2 h after the main meal for the evaluation of postprandial potassium concentrations | ||
| 520 | |a RESULTS: Eighty-two point five percent of patients (33/40) reached normal potassium concentrations at T2. Serum potassium significantly decreased at T2 compared to T0 (5.13 ± 0.48 vs 5.77 ± 0.41 mmol/L, respectively; p < 0.001) and the reduction remained significant during the follow-up (5.06 ± 0.36 at T6 and 5.77 ± 0.41 at T12; p < 0.001 vs T0). Renin-angiotensin-aldosterone system inhibitors were continued by 93% of patients (27/29). Adverse events were reported in 27.5% of patients and were all mild-to-moderate. Postprandial potassium concentrations did not significantly change compared to fasting state potassium measured at T12 (4.53 ± 0.33 vs 5.06 ± 0.36 mmol/L; p = 0.15) | ||
| 520 | |a CONCLUSIONS: In a real-world setting of advanced CKD patients, patiromer is a useful treatment for hyperkalemia, since it significantly reduces serum potassium levels over the long term and is able to maintain potassium concentrations in the normal range even in the post-prandial period | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ACEi | |
| 650 | 4 | |a Chronic kidney disease | |
| 650 | 4 | |a Hyperkalemia | |
| 650 | 4 | |a Patiromer | |
| 650 | 4 | |a Post-prandial | |
| 700 | 1 | |a D'Ercole, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Sannino, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Hamzeh, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a De Marco, Oriana |e verfasserin |4 aut | |
| 700 | 1 | |a Capuano, Ivana |e verfasserin |4 aut | |
| 700 | 1 | |a Buonanno, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Rizzo, Manuela |e verfasserin |4 aut | |
| 700 | 1 | |a Pisani, Antonio |e verfasserin |4 aut | |
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