Kidney Week

Abstract: TH-PO1078

Hyperkalemia Treatment Strategies by Specialty in the TRACK Study: Interim Analysis

Session Information

• CKD: Therapeutic Advances
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Bishop, Meredith S., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Meredith S. Bishop, PharmD

• Hsia, Judith, University of Colorado System, Denver, Colorado, United States

Judith Hsia, MD

• Fried, Linda F., University of Pittsburgh, Pittsburgh, Pennsylvania, United States

Linda F. Fried, MD, MPH, FASN

• Bover, Jordi, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain

Jordi Bover, MD, PhD

• Butler, Javed, Baylor Scott & White Health, Dallas, Texas, United States

Javed Butler, MBBS

• Ferraro, Pietro Manuel, Universita degli Studi di Verona, Verona, Veneto, Italy

Pietro Manuel Ferraro, MD, MS, PhD

• Schneider, Markus P., Friedrich-Alexander-Universitat Erlangen-Nurnberg Medizinische Fakultat, Erlangen, Bayern, Germany

Markus P. Schneider, MD

• Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada

Navdeep Tangri, MD, PhD

• Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States

Wolfgang C. Winkelmayer, MD, ScD, MPH, FASN

• Shivappa, Nitin, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Nitin Shivappa, MBBS, PhD, MPH

• Sundin, Anna-Karin, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Anna-Karin Sundin

• Chen, Hungta (Tony), AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Hungta (Tony) Chen

• Bonaca, Marc P., University of Colorado System, Denver, Colorado, United States

Marc P. Bonaca, MD, MPH

Background

We compared baseline treatment strategies by healthcare provider (HCP) specialty from TRACK, a prospective, observational study designed to address the evidence gap regarding HCP decision making in patients with hyperkalemia (HK).

Methods

TRACK enrolled adults with serum potassium (sK⁺) >5.0 mmol/L and recorded HCP management decisions for 12 months. HCPs were asked, but not required, to record their specialty. An interim analysis was conducted when 600 enrolled participants had completed 6 months. Initial treatment strategy by specialty was compared using Fisher’s exact or Pearson’s Chi-squared tests. Treatment objectives and planned treatment duration were analyzed descriptively.

Results

Participants (N=1330) were enrolled (July 2022–December 2023) in the USA and Europe (mean age, 68±14 years; female, 31%; mean sK⁺, 5.6±0.5 mmol/L; estimated glomerular filtration rate, 28±21 mL/min/1.73 m²). In total, 55% had chronic kidney disease (CKD) without heart failure (HF), 29% had CKD and HF, and 6% had HF without CKD. Overall, nephrologists managed 597 (45%) participants, 327 (25%) had another specified specialty (237 cardiologists), and the HCP specialty was not specified for 30%. Nephrologists were more likely to plan for indefinite treatment, cite CKD guideline compliance as an objective, and prescribe a low K⁺ diet (Table; P<0.0001); less likely to manage renin-angiotensin-aldosterone system inhibitor therapy as an initial strategy and more likely to manage K⁺ binder therapy (both P<0.0001).

Conclusion

HCP specialty affected HK management approaches, possibly reflecting differences in specialty guidelines.

Funding

• Commercial Support – AstraZeneca