Course of Hyperkalemia in Patients on Hemodialysis.

Abstract

Background:

Evidence of longitudinal serum potassium (sK+) concentrations in hyperkalemic hemodialysis patients is sparse.

Objective:

These post hoc analyses of the placebo arm of the phase 3b DIALIZE study (NCT03303521) explored the course of hyperkalemia in hemodialysis patients receiving placebo.

Methods:

In DIALIZE, 196 patients receiving hemodialysis three times weekly were randomized to placebo or sodium zirconium cyclosilicate 5 g starting dose once daily on nondialysis days for 8 weeks. In these post hoc analyses of placebo patients overall (n = 86) and by predialysis sK+ subgroups at randomization <5.5 mmol/L, 5.5 to <6.0 mmol/L, 6.0 to <6.5 mmol/L, and ≥6.5 mmol/L, we assessed mean predialysis sK+ concentration by visit and the proportions of patients with mean predialysis sK+ ranges of 4.0-5.0 and 4.0-5.5 mmol/L by visit.

Results:

In placebo patients, the mean predialysis sK+ concentration at randomization was 5.9 mmol/L, and 5.8 mmol/L at the end of the study (day 57). For placebo patients overall and across all predialysis sK+ subgroups, the mean predialysis sK+ concentration remained ≥5.0 mmol/L for all visits over 8 weeks. Overall, 7-21% and 27-62% of placebo patients had predialysis sK+ ranges of 4.0-5.0 and 4.0-5.5 mmol/L, respectively, at any visit. The proportions of placebo patients with either predialysis sK+ range were greatest for those who were least hyperkalemic (<5.5 mmol/L) and generally decreased with increasing predialysis sK+ concentration.

Conclusions:

Patients receiving placebo and hemodialysis maintained high predialysis sK+ concentrations over 8 weeks following a hyperkalemic event. Most placebo patients remained hyperkalemic and may be at continued risk of adverse events.

• Authors: Bruce Spinowitz, Steven Fishbane, Masafumi Fukagawa, Martin Ford, Nicolas Guzman, Anjay Rastogi
• Journal: International journal of nephrology (Int J Nephrol) Vol. 2022 Pg. 6304571 ( 2022) ISSN: 2090-214X [Print] United States
• PMID: 35531468 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Bruce Spinowitz et al.