Abstract: SA-PO1166
Changes in Albuminuria (ACR) in Patients with Hyperkalemic (HK) CKD Taking Patiromer (PAT) and RAAS Inhibitors (RAASi)
Session Information
- CKD: SGLT2 Inhibitors and GLP-1 RAs for Kidney Health
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Weir, Matthew R., University of Maryland Medical System, Baltimore, Maryland, United States
- Budden, Jeffrey, CSL Vifor, King of Prussia, Pennsylvania, United States
- Williams, John, CSL Vifor, King of Prussia, Pennsylvania, United States
- Desai, Tejas, CSL Vifor, King of Prussia, Pennsylvania, United States
Background
Previous studies showed greater RAASi utilization and lower serum aldosterone levels in CKD patients taking PAT for HK. We assessed changes in ACR in patients in these patients from the OPAL-HK & AMETHYST-DN studies.
Methods
ACR changes from baseline are available from several study groups within the patiromer clinical development program. Part A of OPAL-HK enrolled patients with HK on stable doses of RAASi for 4 weeks (n=234). ACR was measured at baseline & week 4. AMETHYST-DN enrolled 3 cohorts of patients with diabetes & CKD treated with RAASi, in two phases: treatment initiation (TIP) and long-term maintenance (LTMP). Cohorts 1 & 2 (TIP n=61; LTMP n=48) received guideline-directed medical therapy with losartan 100 mg daily, with or without spironolactone and treated with PAT. Cohort 3 patients (TIP n=243; LTMP n=198) had HK on stable doses of RAASi therapy. ACR was measured at baseline & up to 52 weeks.
Results
Median ACR values at baseline & follow-up are described in the figure. Patients experienced reductions in ACR in all 3 albuminuric groups. Macroalbuminuric patients showed a reduction in ACR from a median of 1098 to 813 mg/g. All patients experienced a reduction in ACR in the TIP and LTMP of AMETHYST-DN.
Conclusion
These findings indicate that treatment with PAT, a potassium binder that does not exchange sodium, was associated with decreases in ACR in RAASi-treated CKD patients with HK across all groups. Given the observational nature of these analyses & the variability in patient populations, further studies are needed to confirm these results & clarify their clinical significance.
Figure: Median ACR changes in OPAL-HK (Part A) and AMETHYST-DN studies
Funding
- Commercial Support – CSL Vifor