Journal
CARDIOVASCULAR DRUGS AND THERAPY
Volume 32, Issue 1, Pages 99-119Publisher
SPRINGER
DOI: 10.1007/s10557-017-6767-5
Keywords
Hyperkalemia; Chronic kidney disease; Heart failure; Patiromer sorbitex calcium; Potassium binders; Renin-angiotensin-aldosterone inhibitors; Sodium zirconium cyclosilicate
Funding
- European Regional Development Fund (FEDER)
- Institute of Health Carlos III [PI16/00398, CB16/11/00303]
- Ministerio de Economia y Competitividad [SAF2017-88116-P]
- BBVA Foundation
Ask authors/readers for more resources
Hyperkalemia (serum potassium > 5.5 mEq/L) is a common clinical problem in patients with chronic kidney disease, hypertension, diabetes, and heart failure. It can result from increased K+ intake, impaired distribution between intracellular and extracellular spaces, and most frequently, decreased renal excretion. Patients at the highest risk of hyperkalemia are treated with renin-angiotensin-aldosterone system inhibitors (RAASIs) as they improve cardiovascular and renal outcomes and are strongly recommended in clinical guidelines. However, RAASIs cause or increase the risk of hyperkalemia, a key limitation to fully titrate RAASIs in patients who are most likely to benefit from treatment. Until recently, drugs for the treatment of hyperkalemia presented limited efficacy and/or safety concerns and there was an unmet need of new drugs to control hyperkalemia while maintaining RAASI therapy. We provide an overview of the mechanisms involved in K+ homeostasis and the epidemiology and management of hyperkalemia as a complication in cardiovascular patients and, finally, analyze the efficacy and safety of two new polymer-based, non-systemic agents, patiromer calcium and sodium zirconium cyclosilicate (ZS-9), designed to increase fecal K+ loss and to normalize elevated serum K+ levels and chronically maintain K+ homeostasis in hyperkalemic patients treated with RAASIs.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available