Association of Short- and Long-term SZC Use With Hyperkalemia Hospitalization

Past research suggests that patients receiving long-term treatment with sodium zirconium cyclosilicate (SZC) experience lower rates of hyperkalemia (HK)-related hospitalizations compared with those receiving short-term SZC treatment. With funding from AstraZeneca, Connie Rhee and other researchers used real-world data to compare health care resource use between long-term and short-term users of SZC. Their results were presented at the National Kidney Foundation Spring Clinical Meetings 2024.

The team used HealthVerity, a large US insurance claims database, to identify adults initiating SZC (index date) in the outpatient setting between July 2018 and December 2022. They matched patients with short-term SZC use (≤30 days) to those with long-term SZC use (>90 days) using exact and propensity score matching. There were 3133 matched patient pairs with a mean age of 64 years; 42% were female. Most patients in both cohorts (91%) had kidney disease; 30% had heart failure.

The researchers followed patients to the earliest of 6 months postindex, end of availability of data, other potassium binder use, or restarting of SZC after discontinuation. During follow-up, the investigators compared rates of a composite outcome of HK-related hospitalizations or emergency department (ED) visits and HK-related hospitalizations using generalized estimating equations.

Patients with long-term SZC use had a 40% lower rate of HK-related hospitalizations or ED visits than patients with short-term SZC use (mean [standard deviation] rates per person-year: 0.72 [1.93] vs 1.20 [4.13]) and a 36% lower rate of HK-related hospitalizations (0.55 [1.55] vs 0.87 [2.96]; both P<.001).

Source: Rhee C, et al. Hyperkalemia-related hospitalization associated with short-term vs. long-term outpatient SZC therapy: the GALVANIZE outcomes study. Presented at the National Kidney Foundation Spring Clinical Meetings 2024; May 14-18, 2024; Long Beach, California.