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Comparison of sodium zirconium cyclosilicate and sodium polystyrene sulfonate in the treatment of acute hyperkalaemia.
Eur J Hosp Pharm
December 2024
Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, California, USA
Objective: Sodium polystyrene sulfonate (SPS) and sodium zirconium cyclosilicate (SZC) have been used for treating acute hyperkalaemia. The pharmacodynamic properties of SZC suggest greater theoretical utility in the acute setting than SPS, but there is no clear guidance on an optimal potassium binder. This study evaluated the efficacy of SZC and SPS in the treatment of acute hyperkalaemia.
View Article and Find Full Text PDFEfficacy and Safety of Sodium Zirconium Cyclosilicate in the Management of Hyperkalemia in Patients with Heart Failure with Reduced and Mildly Reduced Ejection Fraction and Chronic Kidney Disease Treated with Spironolactone: rational for and design of the REGISTA-K trial.
J Card Fail
December 2024
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address:
Background: To evaluate whether sodium zirconium cyclosilicate (SZC) enables the uptitration of spironolactone without increasing the risk of hyper- and hypokalemia in patients with heart failure with reduced and mildly reduced ejection fraction (HFrEF and HFmrEF) and moderate/severe chronic kidney disease (CKD) who developed hyperkalemia during treatment with suboptimal spironolactone dose.
Methods: The REGISTA-K is a randomized, double-blind, placebo-controlled, multicenter trial that examined the efficacy and safety of SZC in uptitrating spironolactone without the occurrence of hyperkalemia or hypokalemia. A total of 266 patients with HFrEF and HFmrEF and hyperkalemia will be randomized in a 1:1 ratio to receive either SZC or placebo after treating hyperkalemia with SZC at 25 sites in Japan.
Sodium zirconium cyclosilicate treatment and rates of emergency interventions for hyperkalaemia: a propensity-score weighted case-control study.
Clin Kidney J
November 2024
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Background: Sodium zirconium cyclosilicate (SZC) reduces serum potassium in patients with chronic hyperkalaemia in clinical trials, but its role in the emergency treatment of hyperkalaemia is unproven. We hypothesized that SZC use for emergent hyperkalaemia would be associated with a reduction in rates of emergency interventions for hyperkalaemia.
Methods: This was a single-centre, propensity score-weighted case-control study of patients admitted with hyperkalaemia to a specialist renal centre.
Duration of sodium zirconium cyclosilicate treatment and continuation of RAASi therapy after a hyperkalaemia episode.
ESC Heart Fail
December 2024
Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Aims: Renin-angiotensin-aldosterone system inhibitors (RAASi) are foundational in the management of heart failure (HF) and chronic kidney disease (CKD) but increase the risk of hyperkalaemia. To facilitate continuation of RAASi therapy, guidelines suggest managing hyperkalaemia using newer potassium binders such as sodium zirconium cyclosilicate (SZC). This observational study describes the likelihood of continued RAASi therapy by duration of SZC treatment.
View Article and Find Full Text PDFHyperkalemia management: a multidisciplinary expert panel's perspective on the role of new potassium binders.
Heart Fail Rev
November 2024
NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Hyperkalemia is a potentially life-threatening condition frequently encountered in clinical practice, particularly among patients with chronic kidney disease, heart failure, diabetes, and hypertension and those undergoing treatment with renin-angiotensin-aldosterone system inhibitors (RAASi). The management of chronic and acute hyperkalemia is complex and requires timely intervention to prevent severe complications such as cardiac arrhythmias and sudden death. Traditional therapeutic approaches to chronic hyperkalemia, including dietary potassium restriction, use of diuretics, and administration of cation-exchange resins like sodium polystyrene sulfonate, often suffer from limitations like gastrointestinal side effects, variable efficacy, delayed onset of action, and RAASi treatment discontinuation.
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