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Abstract: SA-PO307

Treatment Response and Dosing of Patiromer in Veterans With Dialysis-Dependent ESKD and Hyperkalemia

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Pinnell, Derek, Salt Lake City VA Medical Center (IDEAS), Salt Lake City, Utah, United States
  • Woods, Steven D., Vifor Pharma Inc., Redwood City, California, United States
  • Boutin, Sylvie, Otsuka Canada Pharmaceutical Inc, Saint Laurent, Quebec, Canada
  • Sauer, Brian C., Otsuka Canada Pharmaceutical Inc, Saint Laurent, Quebec, Canada

Hyperkalemia (HK) is a common, potentially life-threatening metabolic disorder that presents a challenge for clinicians caring for dialysis patients with end-stage kidney disease (ESKD). Patiromer is a non-absorbed, sodium-free potassium (K+)-binding polymer approved for HK treatment. This historical cohort study aimed to describe patiromer utilization and associated serum K+ (sK+) changes in veterans with ESKD and HK on dialysis.


Patiromer utilization and sK+ changes were evaluated using the National VA Corporate Data Warehouse between 1/1/16 and 2/28/21. Inclusion criteria were adults aged ≥18 years old, receiving patiromer, with at least 2 ICD codes for ESKD, on dialysis, and a sK+ ≥5.1 mEq/L recorded within 91 days of the index date (date of first patiromer dispensing). sK+ was assessed at baseline (BL) and 1-, 3-, and 6-months follow-up (FU) from index date. sK+ change from BL to each FU timepoint was assessed by paired t-test.


1,267 patiromer users were identified with ESKD based on ICD code during the BL period; 458 meet the inclusion criteria and had a sK+ available for evaluation during the 3 months pre-index. BL characteristics included mean age 66 years old, 97% male, 45% African American, and mean sK+ 5.91 mEq/L. Comorbidities of interest included 72% diabetes, 50% heart failure, and 45% coronary artery disease. Dosing of patiromer was daily in 87% of cases with an average daily dose of 8.4 g. A dose increase was observed in 11% (n=52) and dose decrease in 5% (n=24) during the FU period. Following patiromer initiation, significant reductions (P<0.01) in mean sK+ concentrations from BL were observed within 1 month (–1.02 mEq/L; n=307), 3 months (–1.04 mEq/L; n=351), and 6 months (–1.05 mEq/L; n=351; Figure).


Among US veterans with ESKD and HK on dialysis, patiromer use was associated with clinically relevant reductions in sK+ concentrations at all study timepoints.


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