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Patiromer

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https://www.readbyqxmd.com/read/28431898/serum-potassium-concentrations-importance-of-normokalaemia
#1
REVIEW
Manuel Heras, María José Fernández-Reyes
Abnormalities in potassium concentrations are associated with morbidity and mortality. In recent years it has been considered that small variations in serum potassium concentrations within normal intervals may also be associated with mortality. Strategies for achieving normokalaemia include dietary measures, limiting the use of potassium retaining drugs, and use of conventional cation exchange resins (calcium/sodium polystyrene sulfonate) and/or the new non-absorbed cation exchange polymer (patiromer).
April 18, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28402156/efficacy-and-safety-of-patiromer-in-hyperkalemia
#2
Saibal Das, Jayanta Kumar Dey, Sumalya Sen, Rishav Mukherjee
BACKGROUND: Patients at the highest risk of hyperkalemia are those with chronic kidney disease (CKD) stages 3 and 4. OBJECTIVE: To evaluate the efficacy and safety of patiromer in hyperkalemia in patients with heart failure or CKD. METHODS: The Cochrane Renal Group's Specialized Register was searched through contact with the Trials' Search Coordinator. We aimed at including randomized controlled trials with patiromer in patients with developed or risks of developing hyperkalemia, comparing against an active comparator or placebo...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28356904/clinical-utility-of-patiromer-sodium-zirconium-cyclosilicate-and-sodium-polystyrene-sulfonate-for-the-treatment-of-hyperkalemia-an-evidence-based-review
#3
REVIEW
Mario V Beccari, Calvin J Meaney
INTRODUCTION: Hyperkalemia is a serious medical condition that often manifests in patients with chronic kidney disease and heart failure. Renin-angiotensin-aldosterone system inhibitors are known to improve outcomes in these disease states but can also cause drug-induced hyperkalemia. New therapeutic options exist for managing hyperkalemia in these patients which warrant evidence-based evaluation. AIM: The objective of this article was to review the efficacy and safety evidence for patiromer, sodium zirconium cyclosilicate (ZS9), and sodium polystyrene sulfonate (SPS) for the treatment of hyperkalemia...
2017: Core Evidence
https://www.readbyqxmd.com/read/28212180/advances-in-the-management-of-hyperkalemia-in-chronic-kidney-disease
#4
Andrea C J Cowan, Elie G Gharib, Matthew A Weir
PURPOSE OF REVIEW: Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia that increases both short-term and long-term mortality. Historically, managing hyperkalemia has relied upon dietary modifications, augmentation of urinary potassium excretion and enhanced enteral potassium elimination. This review discusses current treatments and their limitations and summarizes the evidence supporting novel agents for potassium lowering in patients with CKD. RECENT FINDINGS: The introduction of two novel ion exchange resins represents the first new pharmacologic therapies for hyperkalemia in the last 50 years...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28129247/effectiveness-of-patiromer-in-the-treatment-of-hyperkalemia-in-chronic-kidney-disease-patients-with-hypertension-on-diuretics
#5
Matthew R Weir, Martha R Mayo, Dahlia Garza, Susan A Arthur, Lance Berman, David Bushinsky, Daniel J Wilson, Murray Epstein
OBJECTIVE: Recurrent hyperkalemia frequently limits use of renin-angiotensin-aldosterone system inhibitors (RAASi) in chronic kidney disease (CKD) patients with hypertension, diabetes, and/or heart failure. Patiromer is a sodium-free, nonabsorbed potassium (K)-binding polymer approved by the US Food and Drug Administration for the treatment of hyperkalemia. This post-hoc analysis of OPAL-HK examined the effectiveness and safety of patiromer in reducing serum K in hyperkalemic CKD patients on RAASi, with hypertension, receiving diuretic therapy versus those not on diuretics...
May 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28122118/systematic-review-and-meta-analysis-of-patiromer-and-sodium-zirconium-cyclosilicate-a-new-armamentarium-for-the-treatment-of-hyperkalemia
#6
Calvin J Meaney, Mario V Beccari, Yang Yang, Jiwei Zhao
OBJECTIVE: To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia. DESIGN: A systematic review and meta-analysis of phase II and III clinical trial data was completed. PATIENTS OR PARTICIPANTS: Eight studies (two phase II and four phase III trials with two subgroup analyses) were included in the qualitative analysis, and six studies (two phase II and four phase III trials) were included in the meta-analysis...
April 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27836130/insulin-degludec-lixisenatide-and-patiromer-sorbitex-calcium
#7
Daniel A Hussar, Melissa N White
No abstract text is available yet for this article.
November 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27784004/patiromer-decreases-serum-potassium-and-phosphate-levels-in-patients-on-hemodialysis
#8
David A Bushinsky, Patrick Rossignol, David M Spiegel, Wade W Benton, Jinwei Yuan, Geoffrey A Block, Christopher S Wilcox, Rajiv Agarwal
BACKGROUND: Persistent hyperkalemia (serum potassium (K) ≥5.5 mEq/l) is a common condition in hemodialysis (HD) patients, is associated with increased mortality, and treatment options are limited. The effect of patiromer, a gastrointestinal K binder, on serum K was examined in HD patients. METHODS: Six hyperkalemic HD patients (5 anuric) were admitted to clinical research units for 15 days (1 pretreatment week and 1 patiromer treatment week) and they received a controlled diet with identical meals on corresponding days of pretreatment and treatment weeks...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27754081/os-19-04-chronic-diuretic-therapy-does-not-impair-the-effectiveness-of-patiromer-in-hyperkalemic-patients-with-ckd
#9
Matthew Weir, Martha Mayo, Dahlia Garza, Susan Arthur, Lance Berman, David Bushinsky, Daniel Wilson, Murray Epstein
OBJECTIVE: Diuretics, alone or in combination, are frequently prescribed in chronic kidney disease (CKD) and heart failure (HF) patients to reduce volume, blood pressure, and/or for symptom control. Clinicians may also use them to reduce the risk of hyperkalemia, but high doses of diuretics may lead to adverse events from intravascular volume depletion or gout. Patiromer is a non-absorbed K-binding polymer recently approved by the FDA for the treatment of hyperkalemia (HK). We compared patiromer's effects in RAASi-treated CKD patients with HK on different types of diuretics to patients not receiving diuretics in the treatment phase of OPAL-HK...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754080/os-19-03-treatment-with-patiromer-resulted-in-decreases-in-aldosterone-in-patients-with-chronic-kidney-disease-and-hyperkalemia-on-raas-inhibitors-results-from-opal-hk
#10
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753685/mineralocorticoid-antagonists-in-chronic-kidney-disease
#11
Omar Al Dhaybi, George Bakris
PURPOSE OF REVIEW: Current evidence showcases the pathologic effects of excess aldosterone in promoting glomerular and tubulointerstitial inflammation and fibrosis through various pathways. The place for mineralocorticoid receptor antagonists (MRAs) in chronic kidney disease (CKD) progression is unclear. RECENT FINDINGS: MRAs further reduce albuminuria and blood pressure in CKD patients when used in conjunction with angiotensin-converting enzyme inhibitor or angiotensin receptor blockers...
January 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27687200/hyperkalemia-in-heart-failure
#12
REVIEW
Chaudhry M S Sarwar, Lampros Papadimitriou, Bertram Pitt, Ileana Piña, Faiez Zannad, Stefan D Anker, Mihai Gheorghiade, Javed Butler
Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses...
October 4, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27679520/patiromer-an-oral-calcium-loaded-potassium-binder-kalirrhea-with-calciuresis
#13
EDITORIAL
Michael Emmett, Ankit Mehta
No abstract text is available yet for this article.
October 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27679518/effect-of-patiromer-on-urinary-ion-excretion-in-healthy-adults
#14
David A Bushinsky, David M Spiegel, Coleman Gross, Wade W Benton, Jeanene Fogli, Kathleen M Hill Gallant, Charles Du Mond, Geoffrey A Block, Matthew R Weir, Bertram Pitt
BACKGROUND AND OBJECTIVES: Patiromer is a nonabsorbed potassium-binding polymer that uses calcium as the counterexchange ion. The calcium released with potassium binding has the potential to be absorbed or bind phosphate. Because binding is not specific for potassium, patiromer can bind other cations. Here, we evaluate the effect of patiromer on urine ion excretion in healthy adults, which reflects gastrointestinal ion absorption. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We analyzed the effect of patiromer on urine potassium, sodium, magnesium, calcium, and phosphate in two studies...
October 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27643002/os-19-04-chronic-diuretic-therapy-does-not-impair-the-effectiveness-of-patiromer-in-hyperkalemic-patients-with-ckd
#15
Matthew Weir, Martha Mayo, Dahlia Garza, Susan Arthur, Lance Berman, David Bushinsky, Daniel Wilson, Murray Epstein
OBJECTIVE: Diuretics, alone or in combination, are frequently prescribed in chronic kidney disease (CKD) and heart failure (HF) patients to reduce volume, blood pressure, and/or for symptom control. Clinicians may also use them to reduce the risk of hyperkalemia, but high doses of diuretics may lead to adverse events from intravascular volume depletion or gout. Patiromer is a non-absorbed K-binding polymer recently approved by the FDA for the treatment of hyperkalemia (HK). We compared patiromer's effects in RAASi-treated CKD patients with HK on different types of diuretics to patients not receiving diuretics in the treatment phase of OPAL-HK...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643001/os-19-03-treatment-with-patiromer-resulted-in-decreases-in-aldosterone-in-patients-with-chronic-kidney-disease-and-hyperkalemia-on-raas-inhibitors-results-from-opal-hk
#16
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27609505/managing-hyperkalemia-stepping-into-a-new-frontier
#17
Antony Q Pham, Jessica Sexton, Dexter Wimer, Isha Rana, Timothy Nguyen
Maintaining potassium balance in the body is essential for cellular function. Even a slight increase in normal serum potassium levels (3.5-5.0 mEq/L) can interfere with metabolism, electrical action potentials, and cellular processes. Hyperkalemia is commonly seen in patients with chronic kidney disease (CKD) and in patients on renin-angiotensin-aldosterone system (RAAS) inhibitors. Sodium polystyrene sulfonate (SPS), diuretics, and hemodialysis are currently available methods for removing potassium from the body; however, these options have their limitations...
September 7, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27584929/new-drugs-to-prevent-and-treat-hyperkalemia
#18
Laurence Lepage, Katherine Desforges, Jean-Philippe Lafrance
PURPOSE OF REVIEW: Hyperkalemia is frequent, but occurs mostly in patients with chronic kidney disease and is often the cause of discontinuation or omission of renin-angiotensin-aldosterone system inhibitors in patients with diabetes, chronic kidney disease and heart failure. RECENT FINDINGS: Without much evidence in the literature on its efficacy, sodium polystyrene sulfonate is being used frequently in the clinical setting to treat hyperkalemia. In the last few years, two new promising agents have been developed to treat hyperkalemia - patiromer and sodium zirconium cyclosilicate 9 (ZS-9)...
November 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27548687/patiromer-the-first-potassium-binder-approved-in-over-50-years
#19
REVIEW
Betty N Vu, Alyssa Mae De Castro, David Shottland, William H Frishman, Angela Cheng-Lai
For over 50 years, there have been limited options for the management of hyperkalemia, especially among patients with chronic kidney disease (CKD), diabetic nephropathy, hypertension, and heart failure, who were receiving concomitant renin-angiotensin-aldosterone system (RAAS) inhibitor therapy. Hyperkalemia is a potential, life-threatening electrolyte abnormality that frequently challenges clinicians from maximizing the mortality benefit and organ-protective properties of RAAS inhibitors especially in CKD and heart failure populations...
November 2016: Cardiology in Review
https://www.readbyqxmd.com/read/27521112/gastrointestinal-potassium-binding-more-than-just-lowering-serum-k-patiromer-potassium-balance-and-the-renin-angiotensin-aldosterone-axis
#20
Michael Emmett, Ankit Mehta
Hyperkalemia limits the use of renin-angiotensin-aldosterone axis (RAAS) blockers in patients with renal insufficiency. This can be managed by efforts to increase kaliuresis and by gastrointestinal potassium binding with sodium polystyrene sulfonate, a relatively ineffective agent. Now with the availability of patiromer, RAAS blockers can be used more liberally. In addition, potassium reduction decreases aldosterone, which may be beneficial. Adverse nonepithelial aldosterone effects such as endothelial dysfunction and cardiac fibrosis may be ameliorated...
September 2016: Kidney International
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