Rosano Giuseppe M C, Spoletini Ilaria, Agewall Stefan
Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, via della Pisana, 235, Rome, Italy.
Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Postboks 4956 Nydalen, Oslo, Norway.
Eur Heart J Suppl. 2019 Feb;21(Suppl A):A28-A33. doi: 10.1093/eurheartj/suy035. Epub 2019 Feb 26.
Hyperkalaemia is a life-threatening condition, resulting from decreased renal function or dysfunctional homoeostatic mechanisms, often affecting patients with cardiovascular (CV) disease. Drugs such as renin-angiotensin-aldosterone system inhibitors (RAASi) are known to improve outcomes in CV patients but can also cause drug-induced hyperkalaemia. New therapeutic options exist to enhance potassium excretion in these patients. To this aim, we reviewed pharmacological properties and available data on patiromer and sodium zirconium cyclosilicate for the treatment of hyperkalaemia. These agents have been shown in randomized trials to significantly reduce serum potassium in patients with hyperkalaemia on renin-angiotensin-aldosterone system inhibitors. Additional research should focus on their long-term effects/safety profiles and drug-drug interactions.
高钾血症是一种危及生命的病症,由肾功能减退或体内稳态机制功能失调引起,常影响心血管疾病患者。已知肾素-血管紧张素-醛固酮系统抑制剂(RAASi)等药物可改善心血管疾病患者的预后,但也可能导致药物性高钾血症。目前有新的治疗选择可促进这些患者的钾排泄。为此,我们综述了用于治疗高钾血症的帕替罗姆和环硅酸锆钠的药理特性及现有数据。在随机试验中已表明,这些药物可显著降低服用肾素-血管紧张素-醛固酮系统抑制剂的高钾血症患者的血清钾水平。进一步的研究应聚焦于它们的长期效应/安全性概况以及药物相互作用。