Risk factors for rapid recurrence of hyperkalemia following cessation of sodium zirconium cyclosilicate

Authors

Teruhiko Imamura, Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan.
Nikhil Narang, Advocate Aurora HealthFollow
Koichiro Kinugawa, Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan.

Recommended Citation

Imamura T, Narang N, Kinugawa K. Risk Factors for Rapid Recurrence of Hyperkalemia following Cessation of Sodium Zirconium Cyclosilicate. J Clin Med. 2022;11(23):7096. Published 2022 Nov 30. doi:10.3390/jcm11237096

Affiliations

Advocate Christ Medical Center

Abstract

Background: Sodium zircon`ium cyclosilicate (SZC), a recently introduced potassium binder, is indicated to treat hyperkalemia. SZC is often terminated soon after the normalization of hyperkalemia in real-world clinical practice. We aimed to investigate the risk factors for the rapid recurrence of hyperkalemia following cessation of SZC.

Methods: Patients in whom SZC was discontinued following an improvement in hyperkalemia were followed up for three months. The baseline characteristics that were associated with the rapid recurrence of hyperkalemia (>5.0 mEq/L of serum potassium levels within 3 months) were investigated.

Results: A total of 44 patients terminated SZC following the normalization of hyperkalemia. The median age was 81 (69, 87) years old, and 59% were men. When evaluating baseline characteristics, a higher dose of renin-angiotensin system inhibitors was significantly associated with the recurrence of hyperkalemia (adjusted hazard ratio of 1.26, 95% confidence interval 1.02-1.69, p = 0.045) at a designated cutoff of 2.5 mg/day of equivalent enalapril dose.

Conclusions: SZC should be considered for ongoing continuation after normalization of hyperkalemia, particularly in patients receiving a relatively higher dose of renin-angiotensin system inhibitors.

Document Type

Article

PubMed ID

36498671