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Abstract: PO1165

Disease Course of Hyperkalemia in Patients on Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Spinowitz, Bruce S., New York Presbyterian Queens, Queens, New York, United States
  • Fishbane, Steven, Zucker School of Medicine at Hofstra/Northwell, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, Japan
  • Ford, Martin L., King's College Hospital NHS Trust, London, United Kingdom
  • Guzman, Nicolas Jose, AstraZeneca BioPharmaceuticals Research and Development, Gaithersburg, Maryland, United States
  • Rastogi, Anjay, David Geffen School of Medicine, Los Angeles, California, United States
Background

Hyperkalemia (HK) preceding hemodialysis (HD) is associated with increased risk of mortality and hospitalization. Longitudinal data on serum potassium (sK+) in this population is sparse. This post-hoc analysis of data from the placebo (PBO) arm of DIALIZE (NCT03303521) explored the course of HK in HD pts.

Methods

In DIALIZE, 196 pts were randomized 1:1 to PBO (n=99) or sodium zirconium cyclosilicate (SZC) (n=97) 5 g starting dose once daily on non-dialysis days for 8 weeks (8w), comprising a 4-week SZC dose-titration phase (max 15 g) to achieve target pre-dialysis sK+ 4.0–5.0 mmol/L, and a 4-week stable-dose evaluation phase. All pts received HD TIW and dietary counselling. Post-hoc analysis of PBO pts by baseline (BL) pre-dialysis sK+ included mean pre- and post-dialysis sK+ by visit, and proportions of pts who had mean pre-dialysis sK+ of 4.0–5.0 and 4.0–5.5 mmol/L by visit (including pts receiving rescue therapy).

Results

Mean pre-dialysis sK+ after the long interdialytic interval was 5.9 mmol/L at BL (Day 1) and 5.7 mmol/L at end of treatment (EOT; Day 57) (Figure). Across all BL pt strata, mean pre-dialysis sK+ remained ≥5.0 mmol/L for all study visits (Figure). For pts with BL pre-dialysis sK+ <5.5, 5.5–<6.0, 6.0–<6.5, and ≥6.5 mmol/L, mean pre-dialysis sK+ at EOT was 5.4, 5.9, 5.6, and 5.9 mmol/L, respectively (Figure). Over 8w, only 7.0–23.1% and 31.1–60.6% of PBO pts had a pre-dialysis sK+ of 4.0–5.0 and 4.0–5.5 mmol/L, respectively, at any study visit. Mean post-dialysis sK+ was 3.9 mmol/L at BL and at EOT.

Conclusion

In pts receiving PBO and counselling following a HK event, mean sK+ remains high over 8w. Most pts remain hyperkalemic over this period and are therefore at continued risk of adverse outcomes.

Funding

  • Commercial Support