Hyperkalemia (HK) is defined as serum potassium (K+) >5.0 mEq/L and can often be recurrent. HK can be associated with chronic kidney disease (CKD), heart failure (HF), and the use of renin-angiotensin-aldosterone system inhibitor (RAASi) therapy. Patients with CKD and HF also have higher risk of all-cause mortality associated with HK. However, with a timely and long-term treatment strategy, HK can be effectively managed.
Diet Alone May Not Be a Reliable Treatment Strategy for HK
While recommended in conjunction with other treatments, diet alone may not be a reliable strategy for managing HK. Adherence to a low-potassium diet can be difficult to achieve and adhere to long term and may deprive patients of other important nutrients found in certain fruits and vegetables.
Effective treatment strategies to sustain control of potassium levels is important for patients and healthcare systems alike. HK can significantly impact healthcare costs and cause economic burden to the medical system. A retrospective, claims-based analysis of 5,377 pairs of HK-related and HK-unrelated hospitalizations found that over 1-year post-discharge period, the mean rate of inpatient readmissions was 44% higher for HK-related hospitalizations compared to HK-unrelated hospitalizations within 90 days of index discharge date (24.3% vs 16.8%, respectively).
Optimizing RAASi Therapy in Patients with HK
Use of RAASi therapy to target doses is recommended in patients with HF to improve clinical outcomes. While RAASi medications improve blood flow and reduce the workload on the heart, these drugs can increase potassium levels in patients. Reducing or removing RAASi therapy has been a common approach to managing HK. However, the addition of a potassium binder (K+ binder) can treat the HK. When HK is treated, physicians and patients can focus on their RAASi treatment goals. Additionally, guidelines recommend use of K+ binders to treat HK. The International Society of Nephrology (ISN) came to a similar consensus after convening a group of nephrologists and cardiologists from the American Society for Preventative Cardiology (ASPC), the Heart Failure Association of the European Society of Cardiology (HFA), Kidney Disease Improving Global Outcomes (KDIGO) and the Renal Physicians Association (RPA) to co-create a toolkit for the optimization of RAASi therapy in 2021.
Exploring K+ Binders as a Treatment Option for Patients
Healthcare practitioners play an integral role in managing the long-term health of patients living with recurrent HK by treating HK using guideline recommendations.
Learn more about a novel K+ binder for a broad range of patients with HK here.