Wadhwa Nand K, Kline Jason A, Adapa Sreedhar R
Nephrology Division, NY Health, Stony Brook, NY, USA.
Cooper Medical School of Rowan University, Camden, NJ, USA.
Case Rep Nephrol. 2021 Sep 7;2021:6987456. doi: 10.1155/2021/6987456. eCollection 2021.
Patients with chronic kidney disease (CKD) are at an increased risk of developing hyperkalemia, which can be potentially life threatening. Hyperkalemia is frequently encountered with renin-angiotensin-aldosterone system inhibitor (RAASi) therapy use in patients with CKD and often results in the underdosing or discontinuation of these drugs. RAASi therapy has been proven to delay the progression of CKD, ameliorate proteinuria, and reduce the overall risk of cardiovascular morbidity and mortality. Patiromer is a sodium-free, potassium-binding polymer used for the treatment of hyperkalemia. We present a case series of four patients with Stage 4 or 5 CKD in whom the initiation of dialysis was delayed with the use of patiromer. For one patient, dialysis was delayed by 18 months, whereas the remaining three patients, in whom hyperkalemia was one of the main complications, remain dialysis independent to date.
慢性肾脏病（CKD）患者发生高钾血症的风险增加，这可能会危及生命。在CKD患者中，使用肾素-血管紧张素-醛固酮系统抑制剂（RAASi）治疗时经常会出现高钾血症，这往往导致这些药物剂量不足或停药。RAASi治疗已被证明可延缓CKD的进展，改善蛋白尿，并降低心血管发病和死亡的总体风险。帕替罗姆是一种用于治疗高钾血症的无钠钾结合聚合物。我们报告了一个包含四名4期或5期CKD患者的病例系列，这些患者通过使用帕替罗姆使透析起始时间延迟。对于一名患者，透析延迟了18个月，而其余三名患者，高钾血症是主要并发症之一，迄今为止仍无需透析。
