ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO166

Safety and Efficacy of Patiromer in Kidney and Liver Transplant Recipients

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Grewal, Rickinder, University of Rochester Medical Center, Rochester, New York, United States
  • Audi, Akram, University of Rochester Medical Center, Rochester, New York, United States
  • Taylor, Jeremy G., University of Rochester Medical Center, Rochester, New York, United States
  • Melaragno, Jennifer I., University of Rochester Medical Center, Rochester, New York, United States
  • Dewolfe, David M., University of Rochester Medical Center, Rochester, New York, United States
Background

Patiromer has been FDA approved for the management of chronic hyperkalemia, however, there is a paucity of data regarding its safety and efficacy in transplant recipients.

Methods

We retrospectively reviewed the use of patiromer in 16 transplant recipients at our center from 2016 to 2018 including 9 Kidney, 6 Liver, and 1 Kidney after Liver recipients. Patiromer was given mid-day, separated from immune suppression medications by 3 hours. It was started a median of 24 (8-548) days (d) post-transplant and used for a median of 44 (1-160) d. Maximum dose used was 8.4 g/d in 7, 16.8 g/d in 6, and 25.2 g/d in 3 patients. In 5 (31.3%) patients, patiromer was added to other therapies for hyperkalemia: fludrocortisone in 3, diuretics in 3, and discontinuation of sulfamethoxazole/trimethoprim in 2 for an alternative agent.

Results

Mean serum K decreased (Fig. 1A) though serum Cr did not change (Fig. 1B). Patiromer did not appear to interfere with tacrolimus absorption as 13 (81.3%) patients were within goal tacrolimus trough range 1 week after starting patiromer and no change in mean tacrolimus troughs was seen (Fig. 1C). Serum magnesium decreased from initiation to 1 week later but post-initiation levels were not different from pre-initiation levels (Fig. 1D). 10 (62.5%) patients required magnesium repletion.

There were no adverse events attributed to patiromer and no observed episodes of rejection. 1 patient stopped patiromer due to intolerance, but later resumed the medication without issue. 3 patients were readmitted with hyperkalemia: 1 in the setting of AKI, 1 after self-discontinuing patiromer, and 1 after provider-instructed dose reduction.

Conclusion

In this observational cohort, patiromer appears to be both safe and effective for treating hyperkalemia in kidney and liver transplant recipients.