Practical guidance for the use of potassium binders in the management of hyperkalaemia in patients with heart failure and/or chronic kidney disease

Author:

Campbell Patricia1,McKeveney Paul2,Donegan Kay3,Ataliotis Charlie4,Patton Carol1,Mullan Robert5

Affiliation:

1. Craigavon Hospital, Southern HSC Trust, Portadown, Craigavon

2. Downe Hospital, South Eastern Trust, Downpatrick

3. Daisy Hill Hospital, Newry

4. Downe Hospital, SE HSC Trust, Downpatrick

5. Antrim Hospital, Northern HSC Trust, Antrim

Abstract

Given the critical physiological role of potassium, it is understandable that the development of severe hyperkalaemia requires effective management to reduce its effects, which include muscle weakness, paralysis and cardiac arrhythmias. Hyperkalaemia most often results from the failure of renal adaptation to potassium imbalance. Patients who are most susceptible to the development of hyperkalaemia include those with chronic kidney disease and those with heart failure. These patients are often treated with renin–angiotensin–aldosterone system (RAAS) inhibitors, such as angiotensin-converting enzyme inhibitors and angiotensin II-receptor blockers, but the development of hyperkalaemia can require down-titration or cessation of RAAS inhibitors. This presents a significant challenge to nephrologists, cardiologists and healthcare professionals treating these patients as this can prevent them from receiving maximum guideline-directed RAAS inhibitor therapy. Panellists in this roundtable discussion shared their clinical experiences of using potassium binders to manage hyperkalaemia in patients with chronic kidney disease and patients with heart failure (illustrated with case studies) in Northern Ireland and considered recommendations for the implementation and maintenance of chronic potassium-lowering treatment.

Publisher

Mark Allen Group

Subject

General Medicine

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