e-learning | New treatments for hyperkalaemia

7th May 2020 by Dr Louise Hudman

e-learning | New treatments for hyperkalaemia

There have been two recent new guidelines from NICE on managing hyperkalaemia. The first deals with the snappily named sodium zirconium cyclosilicate. The second deals with patiromer. These are both oral drugs, binding potassium in the GI tract and, as they are not absorbed, it is then excreted.

Who can have these drugs?

Both drugs have the same recommendations. They can be used alongside the standard treatments in emergency care of patients with hyperkalaemia. More importantly for us, they can be used in outpatient care if they have persistent hyperkalaemia and:

  • have CKD stage 3b to 5 OR chronic heart failure AND
  • have K+ of at least 6 mmol/L AND
  • are not taking an optimised dose of a drug that acts on the renin-angiotensin-aldosterone system (RAAS) because of their hyperkalaemia AND
  • are not on dialysis.

Do they work?

There is no evidence that these drugs extend life, nor that they improve quality of life. However, the thinking is that if they allow people to take a higher dose of the RAAS inhibitors or to stay on them longer, that may extend life and improve quality of life.

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