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Management of hyperkalemia: Expert consensus from Kuwait - a Modified Delphi Approach.

Ali AlSahow1, Bassam Bulbanat2, Bassam Alhelal3

  • 1Nephrology division, Jahra Hospital, Al Jahra, Kuwait.

International Journal of Nephrology and Renovascular Disease
|October 10, 2024
PubMed
Summary
This summary is machine-generated.

This consensus provides expert guidance on managing hyperkalemia in heart failure, chronic kidney disease, and hemodialysis patients. It addresses inconsistencies in current guidelines for hyperkalemia treatment.

Keywords:
chronic kidney diseaseheart failurehemodialysishyperkalemiapotassium binders

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Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Hyperkalemia is prevalent in heart failure (HF) patients on renin-angiotensin-aldosterone inhibitors (RAASi), chronic kidney disease (CKD), and hemodialysis.
  • It complicates patient management and limits the use of essential RAASi therapy.
  • New potassium binders like sodium zirconium cyclosilicate (SZC) show efficacy, but inconsistent guidelines hinder their adoption.

Purpose of the Study:

  • To develop a consensus statement for hyperkalemia management in acute settings, HF, CKD, and hemodialysis.
  • To address the lack of standardized treatment protocols in the Arabian Gulf region.
  • To provide practical guidance for healthcare practitioners in Kuwait.

Main Methods:

  • A three-step modified Delphi method involving twelve Kuwaiti experts.
  • Two rounds of voting with an intervening virtual meeting to discuss non-unanimous statements.
  • Development and voting on 44 consensus statements regarding hyperkalemia management.

Main Results:

  • The consensus comprises 44 statements covering hyperkalemia management across various clinical settings.
  • Thirty-six statements achieved unanimous approval in the first round.
  • Four statements were removed and four were approved after revisions in the second round.

Conclusions:

  • Standardized definitions, treatment thresholds, and consistent guidelines are lacking for hyperkalemia management.
  • This consensus aims to establish a unified approach to hyperkalemia treatment in Kuwait.
  • The statement highlights future needs for improved hyperkalemia care.