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Abstract: FR-PO551

Evaluation of Patiromer Monotherapy for Acute Hyperkalemia in an Institutional Setting Based on Presence of Renal Impairment

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical


  • Goriacko, Pavel, Montefiore Health System, Bronx, New York, United States
  • Di Palo, Katherine E., Montefiore Health System, Bronx, New York, United States
  • Sinnett, Mark, Montefiore Health System, Bronx, New York, United States
  • Golestaneh, Ladan, Montefiore Health System, Bronx, New York, United States

Patiromer has been widely studied in patients with renal impairment and chronic hyperkalemia. However, its effectiveness for acute, non-life-threatening hyperkalemia is not well described. We aimed to evaluate patiromer monotherapy in a representative cohort of patients with and without renal impairment at an urban medical center.


Using EHR data, we identified adults treated with a one-time dose of patiromer. Patients with pending HD orders or concomitant hyperkalemia therapy within 3 hours of patiromer administration were excluded. The primary endpoint was mean reduction in serum potassium (sK+) from baseline at 3 distinct time intervals (0 to 6 hours, >6 to 12 hours, >12 to 24 hours) and secondary endpoint was incidence of hypokalemia at 24 hours. Outcomes were compared by presence of renal impairment (defined as eGFR of <60 mL/min).


There were 2048 one-time patiromer doses. Demographics are presented in Table 1. The mean reduction in potassium was 0.4 mEq/L at interval 1, 0.4 mEq/L at interval 2, and 0.4 mEq/L at interval 3 (P <.001 for all compared to baseline). The incidence of hypokalemia was 0.2%. Significant reduction in sK from baseline were noted in both groups at all time intervals. Reduction in sK+ was greater in patients without renal impairment at time intervals 1 and 2 (Figure 1).


A single dose of patiromer was associated with a significant decrease in sK+ and low incidence of hypokalemia. These findings suggest clinical utility of patiromer for episodic hyperkalemia in hospitalized patients with and without renal impairment.

Table 1
 < 60 mL/min>= 60 mL/min
Age, years, mean (SD)69.2 (14.2)64.0 (14.6)
Black or African-American Race, n (%)489 (42.9)323 (35.6)
Latinx Ethnicity, n (%)393 (34.5)336 (37.0)
Sex, female, n (%)536 (47.0)374 (41.2)
Patiromer dose, 8.4g, n (%)879 (77.1)725 (79.8)
Baseline potassium level, n (%)
5-5.5 mEq/L
5.6-6.5 mEq/L
> 6.5 mE/qL

614 (53.9)
519 (45.5)
7 (0.6)

559 (61.6)
345 (38.0)
4 (0.4)


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