ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2156

Efficacy of Sodium Zirconium Cyclosilicate for Treatment of Acute Hyperkalemia in Solid Organ Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Leek, Rachael B., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Rega, Scott A., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Feurer, Irene D., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Concepcion, Beatrice P., Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

Hyperkalemia is a common electrolyte abnormality following solid organ transplant (SOT). Limited data are available to support the use of sodium zirconium cyclosilicate (ZS-9), a novel gastrointestinal potassium (K+) binder, in SOT recipients. The purpose of this study was to evaluate short-term efficacy and safety of ZS-9 in SOT recipients.

Methods

We conducted a retrospective single center study of adult hospitalized SOT recipients who received ZS-9 from 05/20-04/21. The primary endpoint was change in K+ from baseline to within 50 hours of the first dose of ZS-9 among persons not receiving renal replacement therapy (RRT). Data were analyzed using descriptive statistics and multivariable linear models.

Results

The sample included 95 SOT recipients (Table), 68 of whom were not receiving RRT within 50 hours of ZS-9 administration. After adjusting for differences in follow-up time (34+11 hours), serum K+ decreased by 0.88+0.81 mmol/L (p=0.002). The fully longitudinal downward trajectory of K+ through up to 49 hours (p<0.001) is depicted (Figure). Adverse events were infrequent and mild as shown in the Table.

Conclusion

ZS-9 for treatment of acute hyperkalemia in hospitalized SOT recipients was efficacious and safe in this single center study. These findings are important in understanding the utility of ZS-9 broadly in SOT recipients.

Patient Characteristics (n=95)
Age (years)55.7 +/- 12.5
Male Gender73 (76.8)
Race
Caucasian
African American
Asian
Other
-
54 (56.8)
34 (35.8)
5 (5.3)
2 (2.1)
Time from transplant to first dose of ZS-9 (years)4.6 +/- 6.3
Transplanted Organ
Kidney
Liver
Pancreas
Heart
Lung
Multiorgan
-
57 (60.0)
13 (13.7)
1 (1.1)
5 (5.3)
9 (9.5)
10 (10.5)
Renal Replacement Therapy
Hemodialysis
Continuous renal replacement therapy
27 (28.4)
21 (22.1)
6 (6.3)
Adverse Events
Median number per person1 (range 0 to 6)
Hypokalemia
Hypoglycemia
Nausea
Vomiting
Constipation
Diarrhea
Pulmonary edema
Bowel perforation
6 (6.3)
8 (8.4)
2 (2.1)
1 (1.1)
1 (1.1)
5 (5.3)
1 (1.1)
0 (0)

Unless noted, table entries are frequency (%) or mean +/- SD.

Funding

  • Other NIH Support