Bjune Thea, Bøe Thea Bjerkestrand, Kjellevold Stig Arne, Heldal Kristian, Abedini Sadollah
Vear General Practitioner Group, Vear, Vestfold, Norway.
Vestfold Hospital Trust, Medical Clinic, Toensberg, Vestfold, Norway.
Int J Nephrol Renovasc Dis. 2023 Mar 16;16:73-82. doi: 10.2147/IJNRD.S401623. eCollection 2023.
Hyperkalemia is a common metabolic complication of chronic kidney disease (CKD) and is associated with several serious adverse events. We aimed to treat/prevent hyperkalemia using the new of potassium-binders, allowing maintained renin-angiotensin-aldosterone system inhibitors (RAASi) treatment in proteinuric CKD and/or congestive heart failure (CHF) patients.
We conducted a retrospective cohort study in long-term users of potassium binders for chronic hyperkalemia. Patients aged 18 years and older, treated with potassium-binders and who met the reimbursement criteria and indication for RAASi treatment were included.
Fifty-seven percent of the patients were males and mean age was 65 years. During the study period, no patients were admitted to hospital due to hyperkalemia after initiation of potassium binders. Potassium maximum values were significantly lower after treatment. Few patients reported major side effects, and discontinuation was mostly due to normokalemia. We found no significant changes in bicarbonate, serum creatinine or GFR stage after starting potassium binder treatment. All patients on RAASi treatment before initiating potassium-binders were retained on RAASi treatment.
New potassium binders in clinical practice are an easy and safe treatment with few side effects and good tolerance, that significantly lowers the risk of hyperkalemia. Furthermore, and most importantly, patients can be maintained on RAASi treatment.
高钾血症是慢性肾脏病（CKD）常见的代谢并发症，与多种严重不良事件相关。我们旨在使用新型钾结合剂治疗/预防高钾血症，以使蛋白尿性CKD和/或充血性心力衰竭（CHF）患者能够继续接受肾素 - 血管紧张素 - 醛固酮系统抑制剂（RAASi）治疗。
我们对长期使用钾结合剂治疗慢性高钾血症的患者进行了一项回顾性队列研究。纳入年龄在18岁及以上、接受钾结合剂治疗且符合RAASi治疗报销标准和适应症的患者。
57%的患者为男性，平均年龄为65岁。在研究期间，开始使用钾结合剂后，没有患者因高钾血症入院。治疗后钾的最高值显著降低。很少有患者报告严重副作用，停药主要是因为血钾正常。开始钾结合剂治疗后，我们发现碳酸氢盐、血清肌酐或肾小球滤过率（GFR）分期没有显著变化。所有在开始使用钾结合剂之前接受RAASi治疗的患者都继续接受RAASi治疗。
临床实践中的新型钾结合剂是一种简便、安全的治疗方法，副作用少，耐受性好，能显著降低高钾血症风险。此外，最重要的是，患者可以继续接受RAASi治疗。
