Course of Hyperkalemia in Patients on Hemodialysis
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....
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2022/6304571 |
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| author | Bruce Spinowitz Steven Fishbane Masafumi Fukagawa Martin Ford Nicolas Guzman Anjay Rastogi |
| author_facet | Bruce Spinowitz Steven Fishbane Masafumi Fukagawa Martin Ford Nicolas Guzman Anjay Rastogi |
| author_sort | Bruce Spinowitz |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-8bda489595554646b28ea6bd0d26a7c5 |
| institution | Kabale University |
| issn | 2090-2158 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-8bda489595554646b28ea6bd0d26a7c52025-02-03T01:22:58ZengWileyInternational Journal of Nephrology2090-21582022-01-01202210.1155/2022/6304571Course of Hyperkalemia in Patients on HemodialysisBruce Spinowitz0Steven Fishbane1Masafumi Fukagawa2Martin Ford3Nicolas Guzman4Anjay Rastogi5Department of MedicineDepartment of MedicineDivision of Nephrology, Endocrinology and MetabolismDepartment of Renal MedicineGlobal Medicines DevelopmentUCLA CORE Kidney ProgramBackground. 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.http://dx.doi.org/10.1155/2022/6304571 |
| spellingShingle | Bruce Spinowitz Steven Fishbane Masafumi Fukagawa Martin Ford Nicolas Guzman Anjay Rastogi Course of Hyperkalemia in Patients on Hemodialysis International Journal of Nephrology |
| title | Course of Hyperkalemia in Patients on Hemodialysis |
| title_full | Course of Hyperkalemia in Patients on Hemodialysis |
| title_fullStr | Course of Hyperkalemia in Patients on Hemodialysis |
| title_full_unstemmed | Course of Hyperkalemia in Patients on Hemodialysis |
| title_short | Course of Hyperkalemia in Patients on Hemodialysis |
| title_sort | course of hyperkalemia in patients on hemodialysis |
| url | http://dx.doi.org/10.1155/2022/6304571 |
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