Kidney Week

Abstract: FR-PO304

Electrolyte-Related Events Among US Veterans with Hyperkalemia

Session Information

• Fluid and Electrolytes: Clinical
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid and Electrolytes

• 902 Fluid and Electrolytes: Clinical

Authors

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Gosmanova, Elvira, Stratton VA Medical Center and Albany Medical College, Albany, New York, United States

Elvira Gosmanova,

• Woods, Steven D., Relypsa, Inc., a Vifor Pharma Group Company, Redwood City, California, United States

Steven D. Woods,

• Fogli, Jeanene, Relypsa, Inc., a Vifor Pharma Group Company, Redwood City, California, United States

Jeanene Fogli,

• Rowan, Christopher G., COHRDATA, LLC, Santa Monica, California, United States

Christopher G. Rowan,

• Hansen, Jared, Salt Lake City VA Medical Center (IDEAS), Salt Lake City, Utah, United States

Jared Hansen,

• Sauer, Brian C., Salt Lake City VA Medical Center (IDEAS), Salt Lake City, Utah, United States

Brian C. Sauer,

Background

Patiromer is a novel sodium-free potassium-binding polymer for treating hyperkalemia. The real-world impact of patiromer and sodium polystyrene sulfonate (SPS) on clinical outcomes is unclear.

Methods

Using the VA Informatics and Computing Environment (VINCI) database, we assessed the percentage of patients with electrolyte-related hospitalizations and emergency department (ED) visits 1, 3, and 6 months before and after the first patiromer and SPS dispensing (index date). Follow-up exposure was classified as of the index date and followed for 6 months (ITT) or censored at discontinuing/switching (continuous exposure, CE).

Results

193 and 8492 patients initiated patiromer and SPS, respectively. All patients had a pre-index serum potassium ≥5.1 mEq/L and heart failure, diabetes, or renal disease. The percentage of patients with electrolyte-related ED visits and hospitalizations in the ITT population are shown in Figure. Although patient numbers were small in the CE population, decreases in electrolyte-related outcomes at months 1, 3, and 6 post-index were observed for ED visits (-2.9%, -9.6%, and -23.1%, respectively, for patiromer, and -4.1%, -4.1%, and -5.7%, respectively, for SPS) and hospitalizations (-1.2%, -3.8%, and -7.7%, respectively, for patiromer, and -0.5%, -0.9%, and -0.4%, respectively, for SPS).

Conclusion

The greatest reduction in electrolyte-related events was observed post-patiromer initiation. Given the limited number of patiromer users in this database, these findings merit additional study.

Figure. Difference in % of Patients with Electrolyte-Related ED Visits & Hospitalizations Pre-Index vs. Post-Index in the Patiromer and SPS Cohorts (ITT Analysis)

Funding

• Commercial Support –