Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA.
Pediatr Nephrol. 2019 Aug;34(8):1395-1401. doi: 10.1007/s00467-019-04232-8. Epub 2019 Apr 8.
Hyperkalemia is a potentially life-threatening complication of chronic kidney disease (CKD). Dietary potassium restriction is challenging in infants despite low-potassium formulas. Decreasing potassium in formula using patiromer, a new calcium-based cation exchange polymer may be one option to accomplish this; however, data confirming efficacy is lacking.
Varying doses of patiromer were added to prepared Similac Advance and Similac PM 60/40. Measurements of potassium, calcium, sodium, magnesium, and phosphorus were obtained at baseline and at 30 min, 60 min, and 24 h following patiromer administration.
Following pre-treatment with patiromer, the potassium concentration of both formulas decreased. This effect was mild with the lowest dose but increased in a dose-dependent fashion. Treating for 60 min or 24 h did not yield substantially greater effects than treating for 30 min. Calcium levels increased in both formula groups, mostly in a dose-dependent fashion. Changes in magnesium, sodium, and phosphorus were also seen after patiromer pre-treatment.
Pre-treatment with patiromer decreases the potassium concentration of infant formula. Calcium levels increased after treatment as expected with the majority of ion exchange occurring in 30 min. Treatment of formula with patiromer shows promise as a unique option for managing hyperkalemia.
高钾血症是慢性肾脏病（CKD）的一种潜在危及生命的并发症。尽管有低钾配方，但限制婴儿的钾摄入量具有挑战性。使用新型钙基阳离子交换聚合物培特罗默来减少配方中的钾可能是实现这一目标的一种选择；然而，缺乏证实其疗效的数据。
向 Similac Advance 和 Similac PM 60/40 中添加不同剂量的培特罗默。在添加培特罗默前和添加后 30 分钟、60 分钟和 24 小时测量钾、钙、钠、镁和磷的浓度。
在培特罗默预处理后，两种配方的钾浓度均降低。最低剂量时效果轻微，但呈剂量依赖性增加。治疗 60 分钟或 24 小时并不比治疗 30 分钟产生更大的效果。两种配方组的钙水平均升高，主要呈剂量依赖性。培特罗默预处理后，镁、钠和磷也发生变化。
培特罗默预处理可降低婴儿配方的钾浓度。钙水平在治疗后如预期的那样升高，大多数离子交换发生在 30 分钟内。用培特罗默处理配方显示出作为治疗高钾血症的独特选择的潜力。
