TITLE:
Hyperkalemia in Patients on Peritoneal Dialysis: Clinical Use Experience with New Potassium-Binders
AUTHORS:
Gennaro Argentino, Mario Iorio, Alessandra Antonia Mele, Andrea Camocardi, Enrica Emanuela Cascone, Maria Elena Liberti, Adelia Sagliocca, Andrea Pota, Luigi Russo, Maria Luisa Sirico, Germano Terzini, Michele Cavasso, Chiara Mennillo, Francesca Nettuno, Raffaele Genualdo, Giuseppe Surfaro, Lucia Di Micco
KEYWORDS:
SZC, Sodium Zirconium Cyclosilicate, Hyperkalaemia, Peritoneal Dialysis
JOURNAL NAME:
Open Journal of Nephrology,
Vol.14 No.3,
August
26,
2024
ABSTRACT: Background: Patients with end-stage kidney disease (ESKD) on maintenance dialysis have a high risk of developing hyperkalemia. In addition to traditional approaches, a new option for the management of patients on dialysis includes the use of a potassium binder, sodium zirconium cyclosilicate (SZC). We evaluated the effect and safety of SZC in patients with chronic PD. Objective: To present a case series that illustrates the real-world use of new potassium-binders in hyperkalemic patients on peritoneal dialysis. Methods: This case series collected 9 patients on PD with baseline potassium values > 5.5 mmol/l and who were treated with SZC 5 g once a day. Data were collected at baseline and at 1, 2, and 3 months after initiation of treatment. Results: The median age of patients was 64.5 years and the median duration of observation was 90 ± 5 days. It was observed that median serum potassium decreased (5.8 mmol/l at baseline with a range of 5.8 mmol/L - 6.8 mmol/L versus 4.5 in the third month with a range of 3.6 mmol/L - 5.3 mmol/L) after SZC treatment. Adverse events were observed in 2 (22.2%). The unique adverse event was constipation and presented in 2 patients (22.2%). Constipation was mild and transient during the observation period. No adverse events of special interest were reported. Conclusion: Normokalemia was established and maintained in this series of patients treated with SZC. No episodes of hyper- or hypo-kalemia were observed. SCZ had a good safety profile and was well tolerated over 3 months.