Hyperkalemia and the Use of New Potassium Binders a Single Center Experience from Vestfold Norway (The PotBind Study)

Abstract

Thea Bjune,1,* Thea Bjerkestrand Bøe,2,* Stig Arne Kjellevold,3,* Kristian Heldal,4,* Sadollah Abedini3,* 1Vear General Practitioner Group, Vear, Vestfold, Norway; 2Vestfold Hospital Trust, Medical Clinic, Toensberg, Vestfold, Norway; 3Vestfold Hospital Trust, Medical Clinic, Section for Kidney Disease, Toensberg, Vestfold, Norway; 4Department of Transplantation Medicine, Oslo University Hospital and Institute of Health and Society, University of Oslo, Oslo, Norway*These authors contributed equally to this workCorrespondence: Thea Bjune, Vear General Practitioner group, Steinbruddveien 8, Vear, 3173, Norway, Tel [phone], Email [email protected]: Hyperkalemia is a common metabolic complication of chronic kidney disease (CKD) and is associated with several serious adverse events. We aimed to treat/prevent hyperkalemia using the new of potassium-binders, allowing maintained renin-angiotensin-aldosterone system inhibitors (RAASi) treatment in proteinuric CKD and/or congestive heart failure (CHF) patients.Patients and Methods: We conducted a retrospective cohort study in long-term users of potassium binders for chronic hyperkalemia. Patients aged 18 years and older, treated with potassium-binders and who met the reimbursement criteria and indication for RAASi treatment were included.Results: Fifty-seven percent of the patients were males and mean age was 65 years. During the study period, no patients were admitted to hospital due to hyperkalemia after initiation of potassium binders. Potassium maximum values were significantly lower after treatment. Few patients reported major side effects, and discontinuation was mostly due to normokalemia. We found no significant changes in bicarbonate, serum creatinine or GFR stage after starting potassium binder treatment. All patients on RAASi treatment before initiating potassium-binders were retained on RAASi treatment.Conclusion: New potassium binders in clinical practice are an easy and safe treatment with few side effects and good tolerance, that significantly lowers the risk of hyperkalemia. Furthermore, and most importantly, patients can be maintained on RAASi treatment.Keywords: chronic kidney disease, hyperkalemia, potassium-binder, RAASi, CKD, renin-angiotensin-aldosterone system inhibitors

Keywords

• chronic kidney disease – hyperkalemia – potassium-binder – raasi