Long-term patiromer use linked with lower mortality risk in adults with CKD, hyperkalemia
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Key takeaways:
- During study follow-up, 93 patients developed kidney failure with replacement therapy and 134 patients died.
- Patients who used patiromer long-term had a 41% lower risk for mortality.
Long-term patiromer use may be associated with a lower risk of all-cause mortality in adults with chronic kidney disease and hyperkalemia, according to results of published study.
“Hyperkalemia is a common complication of CKD due to impaired kidney potassium,” Yoshitsugu Obi, MD, of the nephrology divisions at the University of Mississippi Medical Center in Jackson, Mississippi, and University of Tennessee Health Science Center in Memphis, wrote. “Patiromer is a potassium binder used for long-term hyperkalemia management, but it remains unclear whether patiromer can improve clinical outcomes.”
Investigators conducted a longitudinal observational study of 854,217 U.S. veterans to examine the relationship between long-term potassium binder use and clinical outcomes. Participants had at least one serum potassium reading of 5.1 mEq/L or higher and were treated at a U.S. Department of Veterans Affairs health care facility from 2016 to 2019.
A total of 308 patients who use patiromer long-term were matched to 308 nonusers. Median eGFR was 23.5 mL/min/1.73 m2, and median potassium level was 5.2 mEq/L. Approximately 45% of patients were on renin-angiotensin system inhibitors at baseline.
Measured outcomes included the composite endpoint of kidney failure with replacement therapy (KFRT) or all-cause death, and all-cause death including post-KFRT.
During follow-up, 93 patients developed KFRT and 134 patients died, according to the results. Patients who used patiromer long-term had a 26% lower risk for the composite outcome and a 41% lower risk for all-cause mortality compared with nonusers.
While the study had limitations, such as a cohort of mostly men with a relatively short follow-up, researchers wrote the findings “indicate long-term potassium binder use for hyperkalemia may improve clinical outcomes in CKD.” For future research, they wrote that the therapy “needs to be evaluated in sufficiently powered randomized clinical trials.”
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