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Deprecated: Implicit conversion from float 269.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Hypertens 2017 ; 35 (Suppl 1): S57-63 Nephropedia Template TP
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Effectiveness of patiromer in the treatment of hyperkalemia in chronic kidney disease patients with hypertension on diuretics #MMPMID28129247
Weir MR; Mayo MR; Garza D; Arthur SA; Berman L; Bushinsky D; Wilson DJ; Epstein M
J Hypertens 2017[May]; 35 (Suppl 1): S57-63 PMID28129247show ga
Objective:: Recurrent hyperkalemia frequently limits use of renin?angiotensin?aldosterone system inhibitors (RAASi) in chronic kidney disease (CKD) patients with hypertension, diabetes, and/or heart failure. Patiromer is a sodium-free, nonabsorbed potassium (K+)-binding polymer approved by the US Food and Drug Administration for the treatment of hyperkalemia. This post-hoc analysis of OPAL-HK examined the effectiveness and safety of patiromer in reducing serum K+ in hyperkalemic CKD patients on RAASi, with hypertension, receiving diuretic therapy versus those not on diuretics. Methods:: Depending on the degree of hyperkalemia at baseline, CKD patients with serum K+ from 5.1 to less than 6.5?mmol/l on RAASi (n?=?243) were assigned to a patiromer of total dose 8.4 or 16.8?g, divided twice daily. Changes in serum K+, and tolerability and safety were assessed over 4 weeks in patients on and not on diuretics. Results:: At baseline, 132 patients used diuretics and 111 were not on diuretics, mean age was 64.3 and 64.0 years, respectively, and 63 and 51% were men. Similar reductions in serum K+ were seen over 4 weeks in both subgroups. At week 4, serum K+ fell by ?0.95?±?0.04?mmol/l with any diuretic and ?1.04?±?0.05?mmol/l with no diuretic. Patiromer was well tolerated, with mild-to-moderate constipation reported as the most common adverse event (7.6 and 14.4% of patients on any diuretic or no diuretic, respectively). Hypokalemia (s-K+ <3.5?mEq/l) was reported in 2.3% of patients on any diuretic and in 3.7% not on diuretics. Conclusion:: The serum K+-lowering efficacy and safety profile of patiromer in hyperkalemia patients with CKD was not compromised by diuretic therapy.