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