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Abstract: PO0891

Serum Potassium Changes in US Veterans Receiving Patiromer with Dialysis-Dependent ESKD and Hyperkalemia

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gosmanova, Elvira O., Albany Medical College, Albany, New York, United States
  • Woods, Steven D., Vifor Pharma, Inc., Redwood City, California, United States
  • Rowan, Christopher G., COHRDATA, San Clemente, California, United States
  • Hansen, Jared, Salt Lake City VA Medical Center (IDEAS), Salt Lake City, Utah, United States
  • Sauer, Brian C., Salt Lake City VA Medical Center (IDEAS), Salt Lake City, Utah, United States
Background

Patiromer is a sodium-free, non-absorbed, potassium (K+)-binding polymer approved for the treatment of hyperkalemia (HK). This retrospective cohort study aimed to describe serum K+ changes in Veterans with HK and end-stage kidney disease (ESKD) receiving dialysis who initiated patiromer.

Methods

Serum K+ concentrations were evaluated pre- and post-patiromer initiation using the National VA Corporate Data Warehouse (1/1/16–8/31/18). Changes in mean serum K+ concentration were compared at 1, 3, and 6 months following first patiromer dispensing (index date) using the paired t-test (pre K+ versus post K+). All patients had a baseline K+ ≥5.1 mEq/L and ESKD. Patients with continuous exposure to patiromer were analyzed. Follow-up began on the index date and ended at first censoring event (discontinuation or switch of index K+ binder, death, end of follow-up, or 6 months post-index).

Results

98 patients with ESKD requiring dialysis and HK initiated patiromer. Patient characteristics at baseline were median age 66 years, African-American race 39%, diabetes 71%, heart failure 40%, and mean K+ value of 6.1 mEq/L (standard deviation = 0.7). The initial dose of patiromer was 8.4 g in 96% of patients with few observed increases in unit dose during the follow-up period. Following patiromer initiation, statistically significant reductions in serum K+ concentration were observed at 1 month (–1.24 mEq/L), 3 months (–1.15 mEq/L), and 6 months (–1.36 mEq/L; Figure).

Conclusion

Among dialysis-dependent US Veterans with HK, patiromer was associated with clinically relevant reductions in serum K+ concentrations at all study time points. These findings warrant additional investigation in a larger dialysis cohort with HK.

Funding

  • Commercial Support