Utilization of Potassium Binders for the Management of Hyperkalemia in Chronic Kidney Disease: A Position Statement by US Nephrologists

Two potassium (K+) binders-patiromer sorbitex calcium and sodium zirconium cyclosilicate-are recommended by international guidelines for the management of hyperkalemia. There is, however, no universally accepted best practice for how to appropriately utilize K+ binders in the long-term clinical management of CKD. A panel of eight US-based nephrologists convened in October 2022 to develop a consensus statement regarding utilizing K+ binders in clinical practice to help manage patients with nonemergent, persistent/recurrent hyperkalemia in CKD. Consensus was reached on the following topics: (1) identifying risk factors for hyperkalemia; (2) serum K+ monitoring before and during K+ binder use; (3) utilizing K+ binders in patients receiving renin-angiotensin-aldosterone system inhibitors and dialysis; and (4) when to initiate K+ binders and their duration of use. These consensus statements for the use of K+ binders may assist the nephrology community in optimizing management of hyperkalemia in patients across the spectrum of CKD. Q 2024 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).