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[Hyperkalemia in Hemodialysis: Use of Sodium Zirconium Cyclosilicate - A Single-center Experience]
Stefano Ferraro1, Sonila Mocka2, Marzia Ciabattoni1
1ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi, Savona.
Abstract:
Potassium is the main intracellular cation, and its serum concentration is finely controlled through various mechanisms to maintain it within the range of 3-5 mmol/L. Hyperkalaemia occurs when the serum concentration of K⁺ exceeds 5.0 mmol/L and can be classified as mild, moderate, or severe. Hyperkalaemia is a serious and potentially life-threatening medical condition, and its incidence tends to increase when comorbid conditions are present, such as diabetes mellitus, heart failure, and renal insufficiency, particularly in the subgroup of patients undergoing haemodialysis, where the incidence of hyperkalaemia is even higher. This leads to an increase in hospitalizations and mortality. Control of potassium in haemodialysis patients has always been a central focus for nephrologists, although chronic management strategies have often been ineffective and poorly tolerated by patients. Recently, two new medications have been introduced for chronic potassium control: Patiromer and Sodium Zirconium Cyclosilicate, the latter approved for use in haemodialysis. We conducted an observational study at our dialysis unit on 28 chronic haemodialysis patients, where after detecting hyperkalaemia, therapy with Sodium Zirconium Cyclosilicate was initiated. We evaluated the potassium levels over time, changes in home treatments, and the drug's tolerability.
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