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Kidney Week

Abstract: PO0889

Efficacy of Patiromer and Sodium Polystyrene Sulfonate on Potassium Levels in Chronic Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jaques, David Antoine, Hopitaux Universitaires Geneve, Geneve, Genève, Switzerland
  • Stucker, Fabien, Reseau hospitalier neuchatelois, Neuchatel, Neuchatel, Switzerland
  • Ernandez, Thomas, Hopital de la Tour, Meyrin, Geneva, Switzerland
  • Alves, Cyrielle, Hopitaux Universitaires Geneve, Geneve, Genève, Switzerland
  • Martin, Pierre-Yves F., Hopitaux Universitaires Geneve, Geneve, Genève, Switzerland
  • Saudan, Patrick, Hopitaux Universitaires Geneve, Geneve, Genève, Switzerland
Background

While hyperkalemia is frequent in haemodialysis (HD) patients and is associated with increased mortality, evidences regarding treatment options are limited. We compared the effect of sodium polystyrene sulfonate (SPS) and patiromer on potassium control in this population.

Methods

After screening 180 prevalent chronic HD patients, we included 52 patients with pre-HD potassium >5.1 mmol/l without potassium binder in a cross-over trial comparing on non-dialysis days SPS 15 g before each meal to patiromer 16.8 g once a day. Treatment duration was four weeks with a 2-week intermediate wash-out period. Treatment attribution order was randomized. Pre-HD potassium level was measured at each dialysis session and tolerability assessed on a semi-quantitative scale from 0 to 10.

Results

45 patients terminated the study without missing values on considered variables. Mean age was 66.3 +/- 19.2 with 74 % male and 44% diabetic patients. Mean weekly pre-HD potassium were 4.5 +/- 0.7 mmol/L and 5.0 +/- 0.5 mmol/L under SPS and patiromer respectively. In mixed linear regression, treatment with SPS was associated with a decrease of 0.47 mmol/L in mean weekly pre-HD potassium compared to patiromer (p<0.001). Tolerability score was 6.0 +/- 2.4 and 7.0 +/- 1.8 under SPS and patiromer respectively (p<0.001).

Conclusion

In chronic HD patients, SPS 15 g before each meal on non-dialysis days resulted in lower pre-HD potassium values as compared to patiromer 16.8 g once a day, although tolerability was poorer. Those findings as well as dose titration need to be tested in larger randomized trials.

Funding

  • Clinical Revenue Support