Real-world use of patiromer in patients with hyperkalaemia: A retrospective study from the Valencian Community

Area of Science:

• Nephrology
• Pharmacology
• Internal Medicine

Background:

• Hyperkalaemia is a common complication in chronic kidney disease (CKD) patients treated with renin-angiotensin-aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRAs).
• Limited real-world data exists on the effectiveness of new potassium binders like patiromer in managing hyperkalaemia in routine clinical practice.

Purpose of the Study:

• To evaluate the real-world effectiveness and safety of patiromer in patients with hyperkalaemia and CKD.
• To assess the impact of patiromer on the continuation of RAASi and MRA therapy.
• To analyze changes in serum potassium levels and adverse events associated with patiromer use.

Main Methods:

• A retrospective, observational, multicentre study was conducted in the Valencian Community.
• Included patients received patiromer for at least 3 months for hyperkalaemia management.
• Primary endpoint was serum potassium evolution at 1, 3, 6, and 12 months; secondary endpoints included RAASi/MRA therapy changes and adverse events.

Main Results:

• Serum potassium levels significantly decreased from a baseline of 5.72 mmol/L to 5.01 mmol/L at 12 months (P < .001).
• Patiromer enabled the continuation of RAASi in 94.9% and MRAs in 98.3% of patients.
• The most common adverse events were gastrointestinal; 13.5% of patients discontinued patiromer, half due to adverse effects.

Conclusions:

• Patiromer demonstrated effectiveness and a favorable safety profile for managing hyperkalaemia in CKD patients under real-world conditions.
• Patiromer facilitates the preservation of RAASi and MRA therapy, which is crucial for managing CKD.
• The study provides valuable real-world evidence supporting patiromer's role in routine clinical care for hyperkalaemia in CKD.