Long-term use of potassium binder patiromer may slow progression of CKD
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Key takeaways:
- Long-term users of patiromer had a 26% lower risk for the composite outcome of kidney failure with replacement therapy.
- Patients had a 41% lower risk for all-cause mortality.
Long-term use of the potassium binder patiromer may improve clinical outcomes among patients with chronic kidney disease and hyperkalemia, according to a study.
“While patiromer use among patients with advanced CKD has been shown to reduce the discontinuation of renin-angiotensin-aldosterone system inhibition therapy, it remains unclear whether patiromer can improve clinical outcomes,” Yoshitsugu Obi, MD, PhD,
an assistant professor in the school of medicine at the University of Mississippi Medical Center, wrote along with colleagues. “The aim was to examine the association of long-term patiromer use with clinical outcomes among hyperkalemic patients.”
Researchers conducted a longitudinal observational study that evaluated a national cohort of 854,217 U.S. veterans. Patients had at least one serum potassium level of 5.1 mEq/L or more and were treated at U.S. Department of Veterans Affairs health care facilities between 2016 and 2019.
Among the 2,004 patients who used patiromer during the study, 666 met long-term use criteria. Researchers matched 308 long-term patiromer users to 308 non-users of the treatment.
Outcomes included a composite endpoint of kidney failure with replacement therapy or all-cause death or all-cause death including post-kidney failure with replacement therapy.
Median eGFR was 23.5 mL/min/1.73 m2, and the median serum K was 5.2 mEq/L. Approximately 45% of patients were on a renin-angiotensin system inhibitor at baseline. During follow-up, 93 patients developed kidney failure requiring renal replacement therapy and 134 died.
According to the findings, long-term patiromer users had a 26% lower risk for the composite outcome of kidney failure with replacement therapy or all-cause death vs. non-users of the treatment. Additionally, long-term patiromer users had a 41% lower risk for all-cause mortality.
“The effectiveness of long-term potassium binder use on clinical hard outcomes among patients with CKD and hyperkalemia needs to be evaluated in sufficiently powered randomized clinical trials,” Obi and colleagues wrote.
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