Potassium Binder Use May Reduce Kidney Failure, Death Risks in CKD

Use of the potassium binder patiromer may reduce the risks for kidney failure and death among patients with chronic kidney disease (CKD) and hyperkalemia, new study findings suggest.

In an observational study of 854,217 mostly male US veterans who experienced at least 1 serum potassium level rise to 5.1 mEq/L or greater, 2004 patients (0.2%) received patiromer, including 666 who used patiromer for more than 30 days. Investigators propensity-score matched 308 patients who used patiromer long term to 308 patients who used patiromer briefly or not at all. The median estimated glomerular filtration rate (eGFR) was 23.5 mL/min/1.73m², and the median serum potassium level was 5.2 mEq/L. No one was receiving dialysis. Approximately 45% of patients were taking renin-angiotensin system inhibitors (RAASi).

The risk for the primary composite outcome of kidney failure or death was a significant 31% lower for long-term patiromer users vs short-term or nonusers in adjusted analyses, Csaba P. Kovesdy, MD, of Memphis VA Medical Center in Memphis, Tennessee, and colleagues reported in Kidney Medicine. Long-term patiromer users also had a significant 55% lower risk for all-cause mortality alone.

The investigators found only nominal differences between groups in kidney failure and RAASi discontinuation.

More than half of long-term patiromer users discontinued patiromer within 6 months, however.

“The effectiveness of long-term potassium binder use on clinical hard outcomes among patients with CKD and hyperkalemia needs to be evaluated in sufficiently powered randomized clinical trials,” Dr Kovesdy’s team wrote.

Disclosure: This research was supported by Vifor Pharma. Please see the original reference for a full list of disclosures.

This article originally appeared on Renal and Urology News