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Evidence summaries

Potassium Binders for Chronic Hyperkalaemia in People with Chronic Kidney Disease

Potassium binders may be effective for chronic hyperkalaemia in people with chronic kidney disease compared with placebo. Level of evidence: "C"

The quality of evidence is downgraded by study limitations (unclear sequence generation and allocation concealment, and blindning) and by heterogeneity.

Summary

A Cochrane review [Abstract] 1 included 15 studies with a total of 1849 subjects with chronic kidney disease. Potassium binders lowered serum potassium levels at the end of treatment (MD -0.62 mEq/L, 95% CI -0.97 to -0.27; 3 studies, n= 277 participants; I² = 92%). Studies were not designed to measure treatment effects on cardiac arrhythmias or major GI symptoms. Patiromer or sodium zirconium cyclosilicate made little or no difference to death in short term (RR 0.69, 95% CI 0.11 to 4.32; 4 trials, n=688; I² = 0%).

Clinical comments

Note

Date of latest search: 2020-09-09

References

  • Natale P, Palmer SC, Ruospo M et al. Potassium binders for chronic hyperkalaemia in people with chronic kidney disease. Cochrane Database Syst Rev 2020;(6):CD013165. [PubMed]

Primary/Secondary Keywords