Real-World Insights on Attitudes and Treatment of Hyperkalemia

To understand barriers related to guideline-directed medical therapy for hyperkalemia, the Renal Physicians Association convened a nephrology expert panel to review and discuss hyperkalemia across a continuum of care providers and settings. The panel focused on real-world solutions and identifying opportunities for more education. The panel discussion started with a review of goals, a presentation on the epidemiology of hyperkalemia, and a review of the latest Kidney Disease: Improving Global Outcomes (KDIGO) guidelines for diabetes management in chronic kidney disease. Following presentations by leading experts in the field, the panelists engaged in a facilitated discussion of incidence and patient management pathways, potassium binders, current KDIGO guidelines and the International Society of Nephrology Optimization of RAASi Therapy Toolkit, barriers to optimal care, and possible solutions to overcome barriers. Consensus emerged that prescriptive protocols, potassium-restrictive diets, and discontinuation of renin-angiotensin-aldosterone system inhibitors are not appropriate treatments.