Vijayakumar Shilpa, Butler Javed, Anker Stefan D
Department of Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY, USA.
Department of Medicine, University of Mississippi, 2500 North State Street, Jackson, MS, USA.
Eur Heart J Suppl. 2019 Feb;21(Suppl A):A41-A47. doi: 10.1093/eurheartj/suy031. Epub 2019 Feb 26.
Hyperkalaemia causes significant burden, and even mild hyperkalaemia has been independently associated with increased morbidity and mortality. Patients with chronic disease states, such as heart failure, hypertension, chronic kidney disease and diabetes mellitus, are increasingly susceptible to the development of hyperkalaemia. Options for management of hyperkalaemia had mainly been limited to short-term, temporizing methods with focus on rapid achievement of normokalaemia. Until recently, there was a lack of safe, efficacious and well-tolerated therapies for long-term management. Two novel potassium binders, patiromer and sodium zirconium cyclosilicate, have recently been approved by the US Food and Drug Administration for the management of hyperkalaemia. This review discusses these potassium binders with focus largely on the clinical implications of these agents in patients with chronic cardiovascular conditions.
高钾血症会造成严重负担,甚至轻度高钾血症也已被证实与发病率和死亡率增加独立相关。患有慢性疾病(如心力衰竭、高血压、慢性肾脏病和糖尿病)的患者越来越容易发生高钾血症。高钾血症的管理方法主要局限于短期的临时措施,重点是快速实现血钾正常。直到最近,仍缺乏用于长期管理的安全、有效且耐受性良好的疗法。两种新型钾结合剂,即帕替罗姆和环硅酸锆钠,最近已获得美国食品药品监督管理局批准用于治疗高钾血症。本综述主要围绕这些钾结合剂在慢性心血管疾病患者中的临床意义展开讨论。