Serum potassium response to single ‐dose sodium zirconium cyclosilicate for the treatment of asymptomatic hyperkalemia in hospitalized patients

AbstractAsymptomatic hyperkalemia can be treated with oral potassium binders. Sodium polystyrene sulfonate (SPS) remains widely utilized despite association with serious adverse events including intestinal necrosis. Sodium zirconium cyclosilicate (SZC) is an alternative that has demonstrated a better safety profile and faster onset. SZC's approved initial dosing is 10 g orally three times daily (TID) for 48 hours, which is how available studies evaluate SZC. The purpose of this study was to assess the efficacy of single-dose SZC compared to TID dosing and to single-dose SPS for the management of asymptomatic hyperkalemia in hospitalized patients.This was a single-center, retrospective chart review evaluating adults with asymptomatic hyperkalemia (K+≥ 4.7 mmol/L) treated with SZC 10 g once, SZC 10 g TID (30 g total), or SPS 15-30 g once. The primary outcome was the proportion of patients achieving normokalemia (K+ 3.3-4.6  mmol/L) within 12-30 hours of the first study dose. Secondary outcomes included average change in potassium within 12-30 hours and 31-54 hours from the first dose.Three hundred fifty-one patients were included in this study. The primary outcome was met in 68 patients (58.1%) in the SZC 10 g group, 51 (43.6%) in the SZC 30 g group, and 81 (69.2%) in the SPS 15-30 g group (p<0.01). The average reduction in potassium in 12-30 hours was 0.70  mmol/L, 0.78 mmol/L, and 0.99 mmol/L in the SZC 10 g, SZC 30 g, and SPS 15-30 g groups respectively (p&l...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: RESEARCH ARTICLE Source Type: research