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Kidney Week

Abstract: PUB368

Management of Hyperkalemia: Real-World Insights from US Patients and Health Care Professionals in the TRACK Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Gosmanova, Elvira O., Albany Medical College and Stratton VAMC, Albany, New York, United States
  • Butler, Javed, Baylor Scott & White Research Institute, Dallas, Texas, United States
  • Contreras, Johanna P, Mount Sinai Hospital, New York, New York, United States
  • Fried, Linda F., VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
  • Kathresal, Amarnath A., Durham Nephrology Associates, Durham, North Carolina, United States
  • Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
  • Chen, Hungta (Tony), AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Desai, Pooja N., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Sanford, Mark, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Shivappa, Nitin, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Hsia, Judith, CPC Clinical Research, University of Colorado, Aurora, Colorado, United States
Background

The prospective TRACK study investigates HK management decisions, their rationale, treatment expectations, and objectives, including patient-reported outcomes, over 12 months in five countries. US results are presented here.

Methods

Baseline demographics and responses to questions about their awareness of HK management strategies were collected from adult patients with HK (K+ >5.0 mmol/L); clinical decision-making responses were collected from HCPs. Data were gathered at 3-month intervals. We conducted descriptive statistical analyses.

Results

Among 229 US patients (mean±SD age: 66.4±13.8 years; 71.2% male), 154 had CKD (67.2%), 6 had HF (2.6%), and 58 had both (25.3%). For most patients (72.1%), the baseline HK episode was not their first. At baseline and Month 12, 48.9% and 47.6% were receiving ACEi/ARB/ARNi. HCP-directed dose adjustment was infrequent; the most common reason for decreasing/interrupting/not increasing ACEi/ARB/ARNi dose was high K+ (Table). The most common HCP-cited HK management strategies were “monitor K+ levels” and “prescribe low K+ diet.” Patients cited awareness of “dietary recommendations,” “prescribed a medication for HK,” and “changes made to medications for other conditions” (Table).

Conclusion

A high proportion of US patients reported being asked to change or stop medications for other conditions to manage HK. HCPs cited HK as a common reason for decreasing/interrupting/not increasing guideline-directed medical therapy for CKD and HF. Better HK management, such as chronic K+ binder use, is needed to enable appropriate RAASi therapy to reduce the progression of, and mortality associated with, CKD and HF.

Funding

  • Commercial Support – AstraZeneca

Digital Object Identifier (DOI)