Intermittent sodium zirconium cyclosilicate for the prevention of hyperkalemia in chronic kidney disease
Year: 2025
Type: article
Abstract: BACKGROUND: Hyperkalemia is a common complication of chronic kidney disease (CKD) that often requires urgent dialysis and increases healthcare costs. Daily sodium zirconium cyclosilicate (SZC) is a safe and effective treatment for the control of serum potassium levels in CKD patients. We studied the efficacy and safety of intermittent SZC therapy for the prevention of hyperkalemia in CKD patients. METHODS: ) therapy once to thrice weekly for at least 3 months from January 2021 to June 2023. Outcome measures included plasma potassium levels, hyperkalemia episodes, hospital admissions, and renal function changes, which were compared to the 6 months period before the initiation of SZC treatment. RESULTS: We studied 36 adult CKD patients. SZC treatment significantly reduced plasma potassium levels from 5.10 (inter-quartile range [IQR] 4.91-5.40) to 4.73 (IQR 4.50-5.10) mmol/l (p = 0.0003). The median incidence of any hyperkalemia reduced from 5.0 (IQR 2.0-8.0) to 1.9 (IQR 0.0-4.7) episode per patient-year (p = 0.0001), and the incidence of urgent treatment for hyperkalemia decreased from 2.0 (IQR 0.0-4.0) to 0.0 (IQR 0.0-1.5) episode per patient-year (p = 0.007). The number of emergency room attendance and hospitalization were not significantly reduced. CONCLUSION: Intermittent SZC treatment may help prevent hyperkalemia in CKD patients. Further research is necessary to ascertain if this benefit translates into improvements in hard clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.
Source: BMC Nephrology
Institutions: Chinese University of Hong Kong, Prince of Wales Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
Funder: Chinese University of Hong Kong
Awards: G2584076198, G288885164, G8691159454
OpenAlex ID: W4410744865