November 27, 2019
In a recent review, a team of researchers investigated the impact of both potassium-binding drugs and high potassium foods for acutely and chronically managing hyperkalemia.
“Hyperkalemia is a life-threatening complication of chronic kidney disease (CKD),” explained Deborah Clegg, PhD, and Biff Palmer, MD. “Risk factors include advanced kidney impairment, diabetes, hypertension, heart failure, and consumption of a [potassium]-enriched diet.”
Drs Clegg and Palmer said that diets high in potassium provide various health benefits, including reductions in blood pressure, stroke risk, and osteoporosis.
“Individuals at the highest risk for developing hyperkalemia are those who would benefit most from high [potassium] diets,” they noted. “Inhibitors of the renin--angiotensin--aldosterone system (RAASi) are effective in reducing cardiovascular events and slowing the progression of CKD, yet hyperkalemia is a risk factor.”
Together, Drs Clegg and Palmer discussed strategies that utilized both high potassium diets and pharmacology to preserve kidney function and reduce cardiovascular events. They published these strategies online in Current Opinion in Nephrology and Hypertension.
According to the researchers, sodium zirconium cyclosilicate and patiromer are new potassium-binding drugs that have been approved for treating patients diagnosed with hyperkalemia. They stated that these treatments are both efficacious in the short-term as well as the long-term treatment of hyperkalemia, and that the binders are effective in treating the disease while patients are also receiving RASSi therapy.
“New [potassium]-binding drugs allow for optimal use of pharmacological therapy, such as RAASi, enhancing their cardiorenal protection,” they explained. “Health benefits from consumption of high [potassium] foods may also be enhanced by use of these binders.”
“In conclusion, there are new well tolerated and effective [potassium]-binding agents for acutely and chronically managing hyperkalemia.”
Clegg DJ, Palmer BF. Potassium binding for conservative and preservative management of chronic kidney disease [published online ahead of print November 9, 2019]. Curr Opin Nephrol Hypertens. doi: 10.1097/MNH.0000000000000564