Management of Hyperkalemia with Patiromer in Real-World Setting

Boston—Csaba P. Kovesdy, MD, and colleagues recently conducted a retrospective cohort study to examine the incidence of hyperkalemia following initiation of patiromer in patients with hyperkalemia on chronic hemodialysis. Results of the study were reported at the NKF Spring Clinical Meetings in a poster titled Real-World Evaluation of Potassium Levels in Hemodialysis Patients Initiating Treatment with Patiromer. Patiromer is a potassium binder indicated for the treatment of hyperkalemia.

The study utilized de-identified electronic health record data from January 2016 to December 2017 from a large dialysis organization in the United States. Hemodialysis patients with a baseline serum potassium ≥5.0 mEq/L who initiated treatment with patiromer were eligible for the study. Patients were followed from the index date (first order for patiromer) to 90 days post index, discontinuation or switch to another treatment, loss to follow-up, or December 31, 2017. Hypokalemia (potassium <3.5 mEq/L) was classified using serum potassium in three sequential 30-day intervals after the index date. The study examined the percentage of patients with ≥1 serum potassium ≤3.5 mEq/L and 30-day hypokalemic rate.

The researchers identified 1166 eligible patients who initiated treatment with patiromer following a serum potassium measurement ≥5.09 mEq/L. Median age of the cohort was 60 years, 56% were women, and median follow-up was 90 days. Continuation of patiromer use was high: 96% of patients were treated through 30 days, 79% through 60 days, and 68% through 90 days. At baseline, median serum potassium was 6.0 mEq/L; 20% of patients had a dialysate potassium concentration <2 mEq/L. The rate of hypokalemia was less than 1% at 12, 2, and 3 months.

In summary, the researchers said, “Among chronic hemodialysis patients, real-world management of hyperkalemia with patiromer was associated with low hypokalemia rates.”

Source: Kovesdy CP, Rowan CG, Leonberg-Yoo A, Fogli J, Connaire JJ, Winkelmayer WC. Real-world evaluation of potassium levels in hemodialysis patients initiating treatment with patiromer. Abstract of a poster presented at the National Kidney Foundation 2019 Spring Clinical Meetings, May 8-12, 2019, Boston, Massachusetts.