Abstract: FR-PO551
Evaluation of Patiromer Monotherapy for Acute Hyperkalemia in an Institutional Setting Based on Presence of Renal Impairment
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders
- 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical
Authors
- Goriacko, Pavel, Montefiore Health System, Bronx, New York, United States
- Di Palo, Katherine E., Montefiore Health System, Bronx, New York, United States
- Sinnett, Mark, Montefiore Health System, Bronx, New York, United States
- Golestaneh, Ladan, Montefiore Health System, Bronx, New York, United States
Background
Patiromer has been widely studied in patients with renal impairment and chronic hyperkalemia. However, its effectiveness for acute, non-life-threatening hyperkalemia is not well described. We aimed to evaluate patiromer monotherapy in a representative cohort of patients with and without renal impairment at an urban medical center.
Methods
Using EHR data, we identified adults treated with a one-time dose of patiromer. Patients with pending HD orders or concomitant hyperkalemia therapy within 3 hours of patiromer administration were excluded. The primary endpoint was mean reduction in serum potassium (sK+) from baseline at 3 distinct time intervals (0 to 6 hours, >6 to 12 hours, >12 to 24 hours) and secondary endpoint was incidence of hypokalemia at 24 hours. Outcomes were compared by presence of renal impairment (defined as eGFR of <60 mL/min).
Results
There were 2048 one-time patiromer doses. Demographics are presented in Table 1. The mean reduction in potassium was 0.4 mEq/L at interval 1, 0.4 mEq/L at interval 2, and 0.4 mEq/L at interval 3 (P <.001 for all compared to baseline). The incidence of hypokalemia was 0.2%. Significant reduction in sK from baseline were noted in both groups at all time intervals. Reduction in sK+ was greater in patients without renal impairment at time intervals 1 and 2 (Figure 1).
Conclusion
A single dose of patiromer was associated with a significant decrease in sK+ and low incidence of hypokalemia. These findings suggest clinical utility of patiromer for episodic hyperkalemia in hospitalized patients with and without renal impairment.
Table 1
| < 60 mL/min | >= 60 mL/min | |
| N | 1140 | 908 |
| Age, years, mean (SD) | 69.2 (14.2) | 64.0 (14.6) |
| Black or African-American Race, n (%) | 489 (42.9) | 323 (35.6) |
| Latinx Ethnicity, n (%) | 393 (34.5) | 336 (37.0) |
| Sex, female, n (%) | 536 (47.0) | 374 (41.2) |
| Patiromer dose, 8.4g, n (%) | 879 (77.1) | 725 (79.8) |
| Baseline potassium level, n (%) 5-5.5 mEq/L 5.6-6.5 mEq/L > 6.5 mE/qL | 614 (53.9) 519 (45.5) 7 (0.6) | 559 (61.6) 345 (38.0) 4 (0.4) |
Funding
- Commercial Support – Vifor