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Sodium zirconium cyclosilicate for the management of chronic hyperkalemia in kidney disease, a novel agent.

Authors :
Rastogi A
Hanna RM
Mkrttchyan A
Khalid M
Yaqoob S
Shaffer K
Dhawan P
Nobakht N
Kamgar M
Goshtaseb R
Sarmosyan K
Gnarini M
Wassef O
Lerma E
Source :
Expert review of clinical pharmacology [Expert Rev Clin Pharmacol] 2021 Sep; Vol. 14 (9), pp. 1055-1064. Date of Electronic Publication: 2021 Jul 06.
Publication Year :
2021

Abstract

Introduction: Hyperkalemia is a common finding in patients with advanced kidney disease for multiple reasons. Renin-Angiotensin-Aldosterone-System Inhibitors (RAASi) that are indicated for slowing down progression of kidney disease are often associated with hyperkalemia which becomes a limiting factor in their use and titration to the maximum dose. Having a safe, effective, tolerable, and affordable potassium binder can help optimize RAAS inhibition in the setting of kidney disease.<br />Areas Covered: Although sodium polystyrene sulfonate has been a mainstay of acute management of hyperkalemia for decades, evidence regarding its efficacy is limited, and its chronic use is not routinely recommended for concerns regarding toxicity. The concern of gastrointestinal (GI) adverse effects with sodium polystyrene sulfonate has spurred the development of alternatives. Sodium zirconium cyclosilicate (SZC) is a promising agent that selectively binds potassium in the gut and eliminates it, while being safe for chronic use based on 1 year of data. Even though we do not have head-to-head studies among the three currently available binders, SZC stands out in rapidity of onset and efficacy.<br />Expert Opinion: In this review, we summarize the general management of hyperkalemia, including new agents. We review the pre-clinical and clinical data relating to sodium zirconium cyclosilicate.

Details

Language :
English
ISSN :
1751-2441
Volume :
14
Issue :
9
Database :
MEDLINE
Journal :
Expert review of clinical pharmacology
Publication Type :
Academic Journal
Accession number :
34227913
Full Text :
https://doi.org/10.1080/17512433.2021.1932460