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Abstract

REVIEW ON MANAGEMENT OF HYPERKALEMIA IN CKD PATIENTS

Nandamuri Sri Thanmayi*, Mandadapu Naga Jyotsna, Panguluri Nadiya, Purushothama Reddy K. and Kantamaneni Padmalatha

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Abstract

Kidney is the main route of potassium excretion, hyperkalemia is usually complicated in patients with advanced chronic kidney disease (CKD). The decrease in glomerular filtration decreases urinary potassium excretion. In patients with high potassium levels, the risk of hyperkalemia increases. intake, advanced age, diabetic mellitus, congestive cardiac failure, and drugs like RAAS blockers. In CKD patients, the benefits of RAAS blockades and a high-potassium diet should be evaluated. Potassium binders have developed as new approaches for enhancing faecal potassium excretion to circumvent these contradicting treatment techniques. Four types of potassium binders are preferred in different parts of the world. While sodium polystyrene sulfonate (SPS) swaps sodium for potassium, calcium polystyrene sulfonate (CPS) exchanges calcium for potassium and so avoids hypervolemia. SPS was first launched in the 1950s and was widely used in Western countries for many years, but CPS is now widely used in Asia, Despite the lack of clinical research utilising SPS or CPS, two newer potassium binders, patiromer and sodium zirconium cyclosilicate (ZS-9), were found to effectively and safely reduce serum potassium levels in CKD patients receiving RAAS blockades in recent randomised, controlled trials. Long-term administration of a small dose of CPS was also effective and safe in the treatment of chronic hyperkalemia, according to our findings. To provide cost-effective care of hyperkalemia in CKD patients, more comparison trials between patiromer, ZS-9, and CPS are needed.

Keywords: Calcium polystyrene sulfonate, Patiromer, Potassium, Sodium polystyrene sulfonate, Sodium zirconium cyclosilicate.


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