Abstract: TH-PO0400
Comparative Efficacy of Sodium Zirconium Cyclosilicate vs. Conventional Therapy for Hyperkalemia: First Brazilian Cohort
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Tapioca, Fernanda Martin, Hospital Ana Nery, Salvador, BA, Brazil
- Passos, Luiz Carlos, Hospital Ana Nery, Salvador, BA, Brazil
- Oliveira Silva, Lílian Liciane, Hospital Ana Nery, Salvador, BA, Brazil
- Carvalho Gama, Jefferson Oliveira, Hospital Ana Nery, Salvador, BA, Brazil
- Gutierrez Peredo, Gabriel Brayan, Hospital Ana Nery, Salvador, BA, Brazil
Group or Team Name
- Nephro-HAN.
Background
Hyperkalemia is a common in-hospital complication and is associated with adverse clinical outcomes. Sodium zirconium cyclosilicate (SZC) represents a newer therapeutic option for the management of this condition.
Methods
This was a retrospective study, conducted in 2024, involving 137 patients with hyperkalaemia. Patients receiving conventional therapy (polarizing solution, furosemide, calcium gluconate, and/or bicarbonate) were compared with those treated with SZC. The primary outcome was the persistence or recurrence of hyperkalaemia, assessed by two consecutive serum potassium measurements following treatment. Binary logistic regression analysis was performed, including an unadjusted model and two models adjusted for potential confounding variables first Brazilian.
Results
A total of 137 patients were analysed (mean age 63.2 ± 17.1 yr); 70% were male and 95% non-white, 60% (n= 82) received conventional therapy . Main comorbidities were hypertension (58%), diabetes (48%) and CKD (42%). The leading cause of Hyperkalemia was acute kidney injury and it was present in 56% of the population. The SZC group had a lower recurrence rate (16.4% vs 32.9%). After the first follow-up, SZC use reduced recurrence odds by 84% (OR: 0.16; p: 0.102). At the second follow-up, SZC was linked to lower risk of persistent hyperkalaemia (OR: 0.36; 95% CI: 0.15–0.83; p: 0.017). This remained significant after adjusting for age, sex, and race (OR: 0.29; 95% CI: 0.12–0.74; p: 0.009), and further for hypertension, diabetes, and heart failure (OR: 0.25; 95% CI: 0.09–0.63; p: 0.004). Diabetes was independent risk factor for persistent hyperkalaemia (OR: 2.77; 95% CI: 1.12–6.85; p: 0.027).
Conclusion
SZC was effective in reducing the persistence of hyperkalaemia compared to conventional therapy, even after adjustment for clinical factors.