A multicenter, prospective, observational study for the real-world treatment of hyperkalemia among patients in the emergency department in China (POETRY-E)
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Hyperkalemia is a common and potentially lethal electrolyte disorder in the emergency department (ED). We aim to explore the real-world effectiveness of hyperkalemia treatment, and the patterns of hyperkalemia management in the ED in China. Methods POETRY-E (ChiCTR2100053100) was a multicenter, prospective, observational study. Adult patients with serum potassium (sK + ) ≥ 5.5 mmol/L admitted to the ED were enrolled from 15 centers across China and followed until discharge from the ED. The primary endpoint was the change in sK + from baseline to 6 h after treatment initiation. Secondary and exploratory endpoints included the clinical burden of hyperkalemia (e.g., severity, complications, survival, etc.), and the real-world management strategies of hyperkalemia in the ED. Results Between October 2021 and March 2023, 577 patients were enrolled. The median (Q1, Q3) baseline sK + was 6.25 (5.82, 6.83) mmol/L. At 6 h, after treatment initiation, the median (Q1, Q3) change in sK + from baseline was − 1.30 (− 1.96, − 0.72) mmol/L ( P < 0.001), with 46.4% ( n = 268) achieving sK + < 5.5 mmol/L. Most patients ( n = 457, 79.2%) received combination therapies, among which 36.1% ( n = 165) received oral potassium binders, predominantly sodium zirconium cyclosilicate (SZC) ( n = 152). The SZC-containing therapies were associated with a lower median (Q1, Q3) sK + at 4 h compared with non-SZC-containing regimens (5.20 [4.90, 5.70] vs. 5.81 [4.99, 6.10] mmol/L, P = 0.019) and a trend towards lower sK + at 6 h (4.98 [4.60, 5.50] vs. 5.20 [4.67, 5.70] mmol/L, P = 0.140). Moreover, the SZC-containing therapies were associated with numerically favorable median (Q1, Q3) change in sK + from baseline compared with non-SZC-containing regimens at 4 and 6 h (4 h: − 1.23 [− 1.65, − 0.70] vs. − 0.94 [− 1.42, − 0.55] mmol/L; 6 h: − 1.42 [− 1.98, − 0.90] vs. − 1.30 [− 1.90, − 0.73]). Death in the ED occurred in 24 (4.2%) patients. Conclusions In Chinese patients with hyperkalemia presented to the ED, hyperkalemia management was effective in rapidly reducing sK + . SZC-containing therapies may be more effective treatment options. Trial registration Chinese Clinical Trial Register (ChiCTR2100053100), registered on November 10, 2021.
Authors: Yangyang Fu, Yao Wu, Yili Dai, Hong Zhan, Danni Li, Guiyun Li, Yuyang Qiu, Laifa Kong, Daoyuan Jing, Yan Shi, Ming Sun, Chao Wu, Fenshuang Zheng, Wencao Liu, Zhijun Zhao, Ying Deng, Junying Kong, Changju Zhu, Qiaofang Wang, Yingying Hu, Jianzhong Yang, Dandan Li, Yingping Tian, Dongqi Yao, Na Meng, Mao Zhang, Yueyang Chai, Jian Guan, Qijun Ou, Kui Jin, Huadong Zhu, Xuezhong Yu, Zhaoxing Tian, Jun Xu
Institutions: Capital Medical University, Beijing Jishuitan Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, The First Affiliated Hospital, Sun Yat-sen University, Xinjiang Medical University, First Affiliated Hospital of Xinjiang Medical University, Jinhua Central Hospital, Zhejiang University, Second People’s Hospital of Huai’an, Nanjing Drum Tower Hospital, Yunnan University, Shanxi Provincial People’s Hospital, Harbin Medical University, Second Affiliated Hospital of Harbin Medical University, First Affiliated Hospital of Zhengzhou University, Henan University of Science and Technology, First Affiliated Hospital of Henan University of Science and Technology, Hebei Medical University, Second Hospital of Hebei Medical University, Second Affiliated Hospital of Zhejiang University, Beijing Hua Xin Hospital, Tsinghua University, University of Science and Technology of China
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7169664857