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Kidney Week

Abstract: PO0584

A Medication Use Evaluation of Patiromer in a Clinical Practice Setting at a Veteran's Affairs Medical Center

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Cooney, Danielle N., Louis Stokes VA Medical Center, Cleveland, Ohio, United States
  • Fox, Emily M., Louis Stokes VA Medical Center, Cleveland, Ohio, United States
  • Low, Mary Beth, Louis Stokes VA Medical Center, Cleveland, Ohio, United States
  • Desai, Niraj, Case Western Reserve University, Cleveland, Ohio, United States
Background

Patiromer is cation exchange polymer approved for treatment of hyperkalemia. There is limited data regarding the utility, adverse effects, frequency of laboratory monitoring and discontinuation rate of Patiromer in a clinical practice setting.

Methods

We performed a retrospective, observational review of veterans prescribed one or more doses of patiromer between 10/2015 and 11/2019 at the Veterans Affairs Northeast Ohio Hospital System (VANEOHS), to evaluate changes to RAAS inhibitor therapy, adverse effects resulting in patiromer discontinuation, and monitoring of serum potassium level. Patiromer prescription characteristics, concomitant medications, laboratory characteristics and adverse effects were collected for each veteran over the study time period. Baseline characteristics are reported as means; relative frequency of outcomes are reported as percentages.

Results

69 Veterans with hyperkalemia were included for analysis. Mean age was 70 years, African-American race 29%, diabetes 90%, chronic kidney disease 91%, 17% ESRD on dialysis, and heart failure 36%. The most common patiromer dose was 8.4 g daily (78%), prescribed for a mean 274 (SD 3-1250) days. 21% of patients had repeat labs within 2 weeks and 54% within 4 weeks of patiromer initiation. 77% of patients achieved normokalemia (K< 5.0 meq/L) by the first follow up lab draw.

Amongst 52 veterans with chronic, continuous patiromer use, 22 (41%) were taking RAAS inhibitors at baseline; 15 (29%) veterans either maintained or increased RAAS inhibitor dose over the study period. 28 (54%) discontinued patiromer with 7 (25%) veterans doing so due to GI complaints.

Conclusion

In a clinical setting at a Veteran’s Affairs hospital, patiromer therapy preserved RAAS inhibitor use and improved serum potassium levels, but was discontinued at a high rate due to adverse effects