Institute of Medical and Biomedical Education, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
Renal and Transplantation Department, St George's, University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, UK.
Curr Heart Fail Rep. 2022 Aug;19(4):191-199. doi: 10.1007/s11897-022-00552-3. Epub 2022 Jun 15.
Heart failure (HF), in conjunction with common comorbidities such as chronic kidney disease and diabetes and medical therapies such as RAASi, predisposes to hyperkalaemia which may lead to hospitalisation and death. This paper aims to review the most current evidence surrounding the risks and management of hyperkalaemia in HF, with particular focus on recent research into RAASi including novel selective mineralocorticoid receptor blockers and novel potassium binders.
The most recent evidence shows that even moderate hyperkalaemia may predispose to adverse outcomes such as hospitalisation and death. Furthermore, it may prevent patients from receiving optimal medical therapy for HF by reducing prescription of RAASi therapy. Novel potassium binders such as sodium zirconium cyclosilicate (SZC) and patiromer present potential options to reduce and prevent hyperkalaemia as well as maintain optimal RAASi dosing in HF. Management of hyperkalaemia in HF has advanced in recent years. New therapies such as SZC and patiromer are contributing to the management of acute hyperkalaemia and also access to life-saving RAASi therapies by tackling and preventing hyperkalaemia in the community.
心力衰竭（HF）与慢性肾脏病和糖尿病等常见合并症以及 RAASi 等医学治疗共同导致高钾血症，可能导致住院和死亡。本文旨在回顾 HF 中高钾血症风险和管理的最新证据，特别关注 RAASi 最近的研究，包括新型选择性盐皮质激素受体阻滞剂和新型钾结合剂。
最近的证据表明，即使是中度高钾血症也可能导致不良后果，如住院和死亡。此外，它可能会通过降低 RAASi 治疗的处方来阻止患者接受 HF 的最佳药物治疗。新型钾结合剂，如硅酸锆钠（SZC）和帕替罗尔，为降低和预防高钾血症以及在 HF 中维持最佳 RAASi 剂量提供了潜在选择。HF 中高钾血症的管理近年来取得了进展。新型治疗方法如 SZC 和帕替罗尔通过在社区中解决和预防高钾血症，有助于急性高钾血症的管理以及获得挽救生命的 RAASi 治疗。
