Managing Hyperkalemia in High-Risk Patients in Long-Term Care

被引:0
作者
Kumar, Rajeev [3 ]
Kanev, Leo [2 ]
Woods, Steven D. [5 ]
Brenner, Melanie [1 ]
Smith, Bernie [4 ]
机构
[1] Opko Hlth, Miami, FL USA
[2] Northwest Suburban Phys, Arlington Hts, IL USA
[3] Midwest Geriatr LLC, 6101 S Cty Line Rd, Burr Ridge, IL 60527 USA
[4] Remedy Senior Care, Waxhaw, NC USA
[5] Relypsa Inc, Redwood City, CA USA
关键词
CHRONIC KIDNEY-DISEASE; SODIUM ZIRCONIUM CYCLOSILICATE; CONVERTING ENZYME-INHIBITORS; LEFT-VENTRICULAR DYSFUNCTION; HEART-FAILURE; POLYSTYRENE SULFONATE; SERUM POTASSIUM; CONTROLLED TRIAL; LOOP DIURETICS; MORTALITY;
D O I
暂无
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Hyperkalemia is common among elderly patients and is associated with an increase in morbidity and mortality. Patients at highest risk for developing hyperkalemia are those with chronic kidney disease (CKD) and heart failure (HF), particularly those on guideline-recommended inhibitors of the renin-angiotensin-aldosterone system (RAAS). Hyperkalemia remains a challenge for clinicians practicing in the longterm care setting as they are often faced with the difficult decision of down-titrating or discontinuing RAAS inhibitors in response to hyperkalemia in the very patients who derive the greatest benefit from these agents. In the past, options to chronically manage hyperkalemia were limited. Patiromer was approved for the treatment of hyperkalemia in 2015 and has been shown to maintain normokalemia for up to 52 weeks in patients with CKD and/or HF on RAAS inhibitors. With the emergence of a new hyperkalemia treatment, there could be a paradigm shift away from the discontinuation of guideline recommended therapies, allowing the continuation of RAAS inhibitor therapy to effectively manage HF symptoms and reduce the risk of rehospitalization in patients with HF, and slow the progression to end-stage renal disease in patients with CKD.
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收藏
页码:S27 / S36
页数:10
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