What can I do about high potassium levels?

Lower potassium levels

jb | The therapeutic options for hyperkalemia are so far unspecific. For example, if the resting membrane potential of the heart muscle cells and the conduction system is stabilized by intravenous administration of calcium, the potassium is shifted intracellularly by means of β2-Mimetic inhalation or administration of glucose solution and old insulin or the excretion of potassium is promoted by furosemide. A potassium-binding polymer has now been successfully tested in a phase II study to determine the dose and evaluate long-term safety. Patiromer is a non-absorbable polymer that binds potassium in the gastrointestinal tract. This leads to increased excretion and reduced absorption. This then eventually causes the blood level to drop.

The 306 included patients with type 2 diabetes and impaired renal function (GFR 15 to <60 ml / min × 1.73 m2) had slightly or moderately elevated potassium levels at the beginning; all received RAAS inhibitors. Depending on the extent of the hyperkalemia (mild or moderate), they received a starting dose of 4.2 g, 8, 4 or 12.6 g or 8.4 g, 12.6 g or 16.8 g patiromer twice daily. The dose was then titrated until the potassium levels normalized. From the fourth week of treatment onwards, a significant reduction in potassium levels could be seen and this continued over the entire observation period of 52 weeks. Due to the significant reduction in potassium levels after four weeks and the low rate of hypokalemia, starting doses of 8.4 g / d and 16.8 g / d were identified for the phase III study. The most common side effects were hypomagnesaemia and mild to moderate constipation. Approval has already been applied for in the USA. |