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Abstract: TH-PO361

Rates of Emergency Temporary Central Venous Access and Emergency Haemodialysis in the Advent of Lokelma: A Retrospective Case Series in a Tertiary Renal Unit

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Marshall, Will, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, United Kingdom
  • Curran, Gabriel Alexander, University of Glasgow, Glasgow, Glasgow, United Kingdom
  • Traynor, Jamie P., NHS Greater Glasgow and Clyde, Glasgow, Glasgow, United Kingdom
  • Mark, Patrick Barry, University of Glasgow, Glasgow, Glasgow, United Kingdom
  • Lees, Jennifer S., University of Glasgow, Glasgow, Glasgow, United Kingdom
Background

The value of Lokelma (sodium zirconium cyclosilicate) in the emergency treatment of hyperkalaemia is yet to be proven. We hypothesised that its use would be associated with a reduction in emergency temporary central venous access (CVC) and emergency haemodialysis (HD).

Methods

We conducted a retrospective case series of patients admitted to our unit with hyperkalaemia, comparing before (Jan 2018 – Dec 2019) and after (Apr 2021 – Sept 2022) Lokelma was available. All patients with a potassium >5.5 mmol/L treated with at least one ≥10g dose of Lokelma were analysed (post-Lokelma period). Patients treated with alternative potassium binders in the post-Lokelma period were excluded. A random number generator selected a comparator group of patients admitted with a serum potassium >5.5 mmol/L (pre-Lokelma period). Multivariable-adjusted logistic regression models determined likelihood of emergency temporary CVC and emergency HD.

Results

Of the 1668 patients admitted in the post-Lokelma period, 271 were suitable for analysis. 265 patients were selected from the pre-Lokelma period. Participants in both periods were well matched (Figure 1). In the post-Lokelma period, patients were 69% less likely to require emergency temporary CVC (OR 0.31; CI 0.21 – 0.47) and 73% less likely to need emergency HD (OR 0.27; CI 0.18 to 0.40). These results were consistent after sequential adjustment for potential explanatory variables (Figure 2).

Conclusion

Lokelma was associated with a signification reduction in emergency temporary CVC and emergency HD in patients presenting to a tertiary renal unit with hyperkalaemia.