Hyperkalemia | TreatmentTrends | US | 2015

Hyperkalemia describes elevated levels of potassium in the blood. Although often asymptomatic, it can, if left untreated, cause cardiovascular problems, resulting in electrocardiogram (ECG) abnormalities (i.e., arrhythmias) and increased mortality. Hyperkalemia can occur for a number of reasons, including renal disease, diabetes, and treatment with medications such as RAAS inhibitors (e.g., ACE inhibitors, ARBs, MRAs). Consequently, certain patient populations are associated with hyperkalemia; they include patients with chronic kidney disease (CKD), heart failure, and diabetes. Effective and tolerable treatment options are lacking for hyperkalemia. Thus, novel hyperkalemia therapies are needed that can safely lower potassium in a rapid and sustained manner in both the acute and chronic settings. Two novel potassium-binding therapies are in development for hyperkalemia: Relypsa’s patiromer (RLY-5016) and ZS Pharma’s ZS-9 (zirconium silicate). Both agents have completed Phase III development in hyperkalemia patients and new drug applications are currently under review by the FDA. This report offers a snapshot into the current and anticipated treatment of hyperkalemia from the perspective of practicing nephrologists and cardiologists.