TY - JOUR
T1 - Potassium binding for conservative and preservative management of chronic kidney disease
AU - Clegg, Deborah J.
AU - Palmer, Biff F.
N1 - Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Purpose of reviewHyperkalemia is a life-Threatening complication of chronic kidney disease (CKD). Risk factors include advanced kidney impairment, diabetes, hypertension, heart failure, and consumption of a K+-enriched diet. High-K+ diets provide health benefits to include reductions in blood pressure, stroke risk, and osteoporosis. Individuals at the highest risk for developing hyperkalemia are those who would benefit most from high K+ diets. Inhibitors of the renin-angiotensin-aldosterone system (RAASi) are effective in reducing cardiovascular events and slowing the progression of CKD, yet hyperkalemia is a risk factor. Discussed are new strategies facilitating use of both high-K+ diets and pharmacology to preserve kidney function and reduce cardiovascular events.Recent findingsSodium zirconium cyclosilicate and patiromer are new K+-binding drugs approved for the treatment of hyperkalemia. Both are efficacious in the short-Term and long-Term treatment of hyperkalemia. These binders are effective in treating hyperkalemia while facilitating RAASi therapy.SummaryHyperkalemia is a life-Threatening condition. New K+-binding drugs allow for optimal use of pharmacological therapy, such as RAASi, enhancing their cardiorenal protection. Health benefits from consumption of high K+ foods may also be enhanced by use of these binders. In conclusion, there are new well tolerated and effective K+-binding agents for acutely and chronically managing hyperkalemia.
AB - Purpose of reviewHyperkalemia is a life-Threatening complication of chronic kidney disease (CKD). Risk factors include advanced kidney impairment, diabetes, hypertension, heart failure, and consumption of a K+-enriched diet. High-K+ diets provide health benefits to include reductions in blood pressure, stroke risk, and osteoporosis. Individuals at the highest risk for developing hyperkalemia are those who would benefit most from high K+ diets. Inhibitors of the renin-angiotensin-aldosterone system (RAASi) are effective in reducing cardiovascular events and slowing the progression of CKD, yet hyperkalemia is a risk factor. Discussed are new strategies facilitating use of both high-K+ diets and pharmacology to preserve kidney function and reduce cardiovascular events.Recent findingsSodium zirconium cyclosilicate and patiromer are new K+-binding drugs approved for the treatment of hyperkalemia. Both are efficacious in the short-Term and long-Term treatment of hyperkalemia. These binders are effective in treating hyperkalemia while facilitating RAASi therapy.SummaryHyperkalemia is a life-Threatening condition. New K+-binding drugs allow for optimal use of pharmacological therapy, such as RAASi, enhancing their cardiorenal protection. Health benefits from consumption of high K+ foods may also be enhanced by use of these binders. In conclusion, there are new well tolerated and effective K+-binding agents for acutely and chronically managing hyperkalemia.
KW - hyperkalemia
KW - patiromer
KW - potassium
KW - renin-angiotensin-aldosterone system inhibitors
KW - sodium zirconium cyclosilicate
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U2 - 10.1097/MNH.0000000000000564
DO - 10.1097/MNH.0000000000000564
M3 - Review article
C2 - 31714287
AN - SCOPUS:85075957071
SN - 1062-4821
VL - 29
SP - 29
EP - 38
JO - Current opinion in nephrology and hypertension
JF - Current opinion in nephrology and hypertension
IS - 1
ER -