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Abstract: TH-PO362

The Beneficial Effect of Sodium Zirconium Cyclosilicate on the Continuity of Renin-Angiotensin-Aldosterone System Inhibitors in the Management of Hyperkalemia: A Retrospective Observational Study

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

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

Authors

  • Minatoguchi, Shun, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Kimura, Wakana, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Mizuno, Tomohiro, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Koide, Shigehisa, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Hayashi, Hiroki, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Hasegawa, Midori, Fujita Ika Daigaku, Toyoake, Aichi, Japan
  • Inaguma, Daijo, Fujita Ika Daigaku Banbuntane Byoin, Nagoya, Aichi, Japan
  • Tsuboi, Naotake, Fujita Ika Daigaku, Toyoake, Aichi, Japan
Background

Sodium zirconium cyclosilicate (SZC), a non-absorbed non-polymer zirconium silicate, is a new potassium binder for hyperkalemia. A previous report showed that the administration of SZC in patients with hyperkalemia allows a higher continuation rate of renin-angiotensin-aldosterone system inhibitors (RAASi). However, few comparative studies have focused on the clinical utility between SZC and existing potassium binders. The purpose of this study was to evaluate the effect of SZC on the continuation of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) in patients with hyperkalemia compared to that of calcium polystyrene sulfonate (CPS).

Methods

Patients treated with ACEIs/ARBs, who were newly prescribed SZC or CPS for hyperkalemia at a tertiary referral hospital between August 2020 and April 2022, were enrolled in this single-center, retrospective observational study. The primary outcome measure was ACEIs/ARBs prescription three months after the initiation of potassium binders.

Results

A total of 174 patients on ACEIs/ARBs who were newly administered SZC (n=62) or CPS (n=112) were analyzed. The prescription rate of ACEIs/ARBs at three months was significantly higher in the SZC group than in the CPS group (89% vs. 72%). Multivariate logistic regression models showed that SZC was independently associated with the primary outcome (odds ratio 2.66, 95% confidence interval 1.05-7.43). The propensity score-matched comparison also showed a significant association between SZC and the primary outcome.

Conclusion

The current study demonstrated that the administration of SZC in patients with hyperkalemia allows for a higher continuation rate of ACEIs/ARBs than CPS. These findings suggest that SZC have potential benefits for patients with hyperkalemia receiving RAASi.