Abstract: PO2156
Efficacy of Sodium Zirconium Cyclosilicate for Treatment of Acute Hyperkalemia in Solid Organ Transplant Recipients
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
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 Gender | 73 (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 person | 1 (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