Abstract: FR-PO978
Observations from the LiFT Study: Lokelma for Maximization of RAASi in Patients with CKD and Heart Failure, Ongoing Trial
Session Information
- CKD Interventions: Trials and Quality Improvement
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Ali, Mahrukh Ayesha, St George's University of London, London, United Kingdom
- Murphy, Daniel, St George's University of London, London, London, United Kingdom
- Tumelty, Ella H., St George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Chung, Isaac Wen Yao, St George's University of London, London, London, United Kingdom
- Lopez, Tony William, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Parmar, Simran, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Paul, Riny, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Abat, Sharirose, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Anderson, Lisa J., St George's University of London Cardiology Clinical Academic Group, London, United Kingdom
- Banerjee, Debasish, St George's University of London Cardiology Clinical Academic Group, London, United Kingdom
Background
The management of patients with chronic kidney disease (CKD) and heart failure (HF) - CKD-HF poses a clinical challenge. The use of renin-angiotensin-aldosterone inhibitors (RAASi) reduces hospital admissions due to fluid overload and has mortality benefit; however, this is limited by hyperkalaemia, and concerns of worsening renal function. The purpose of this trial is to evaluate the role of sodium zirconium cyclosilicate (SZC) in maximizing of RAASi in CKD-HF. We present preliminary data regarding uptitration of RAASi achieved as part of the study
Methods
This is a double blind, placebo-controlled, phase III randomised control trial. The primary outcome is to compare SZC and Placebo with respect to enabling patients to achieve the maximum tolerated RAASi dose while keeping [K+] < 5.6mmol/L. Secondary outcomes include the number and maximum doses of ACEi/ARBs (angiotensin converting enzyme inhibitors/angiotensin receptor blockers) and MRA (mineralocorticoid receptor blockers) achieved during the study period
Results
We present preliminary data regarding up-titration of RAASi achieved for 35 patients who have completed the trial so far, having started with none or sub-optimal RAASi. The mean age of participants is 74 years. Of the 35 participants, 34 achieved uptitration to maximum tolerated doses in the treatment duration of 2 to 12 weeks. There was no significant change in the eGFR at end of treatment compared to start
Conclusion
While the study is ongoing preliminary data suggests that rapid maximization of RAASi in this frail, comorbid group can be achieved without detriment to renal function
Funding
- Commercial Support – AstraZeneca