Please use this identifier to cite or link to this item: https://doi.org/10.7759/cureus.45058
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dc.titleA Real-World Experience of Hyperkalemia Management Using Sodium Zirconium Cyclosilicate in Chronic Hemodialysis: A Multicenter Clinical Audit.
dc.contributor.authorKhan, Behram Ali
dc.date.accessioned2023-09-12T06:28:56Z
dc.date.available2023-09-12T06:28:56Z
dc.date.issued2023-09-11
dc.identifier.citationKhan, Behram Ali (2023-09-11). A Real-World Experience of Hyperkalemia Management Using Sodium Zirconium Cyclosilicate in Chronic Hemodialysis: A Multicenter Clinical Audit.. Cureus 15 (9). ScholarBank@NUS Repository. https://doi.org/10.7759/cureus.45058
dc.identifier.issn2168-8184
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/244897
dc.description.abstractIntroduction: Hyperkalemia, a common condition among hemodialysis (HD) patients, is associated with adverse health outcomes. Evidence of the safety and efficacy of a potassium-binder, sodium zirconium cyclosilicate (SZC), has been limited among Asian (HD) patients beyond phase 3 trials. This article demonstrates real-world evidence of SZC usage in an Asian cohort of HD patients. Methods: A retrospective clinical audit was conducted among 293 patients who received maintenance HD at community-based dialysis centers in Singapore. Patients received SZC for either management of hyperkalemia or hyperkalemia prevention during anticipated disruption to dialysis, such as during traveling. Among patients treated for hyperkalemia (N = 147), serum potassium (K+) prior to SZC initiation and at the endpoint was compared using a paired Student’s t-test. Changes in K+ from baseline to endpoint were compared across various categories within each demographic and health-related variables using either Student’s t-test or one-way ANOVA. Patients who experienced adverse events after SZC initiation or were deceased during the audit were reviewed to provide a descriptive account. Results: Among patients who received SZC for hyperkalemia treatment, SZC use was associated with a significant reduction of 0.812 mmol/L in serum potassium. Patients with ethnicities other than Chinese, Malay, or Indian had a nominal reduction in K+ of 0.7 mmol/L and this can be accounted for the small sample size of this sub-group. The three main ethnicities which represented more than 95% of the sample showed a significant reduction in K+ levels (all three p<0.001). This is consistent with other studies with SZC which showed efficacy across various ethnicities. Patients who received SZC for hyperkalemia treatment or prevention had a significant lowering of mortality rate. This mortality reduction may have inherent biases and confounders, due to the retrospective clinical audit study design. Conclusions: Overall, SZC was safe and effective among the audited patients. The efficacy in the real-world setting was similar to previous trials. The novel use of SZC to manage serum potassium when HD sessions are missed, such as during traveling, warrants further investigation due to potentially significant life-saving implications.
dc.publisherCureus, Inc.
dc.sourceElements
dc.subjectsodium zirconium cyclosilicate
dc.subjectAsian patients
dc.subjectintradialytic
dc.subjectpotassium binders
dc.subjectnormokalemia
dc.subjecthemodialysis complication
dc.subjectinternational and travel medicine
dc.subjectdialysis center
dc.subjectchronic hemodialysis
dc.subjectsevere hyperkalemia
dc.typeArticle
dc.date.updated2023-09-11T23:21:36Z
dc.contributor.departmentMEDICINE
dc.description.doi10.7759/cureus.45058
dc.description.sourcetitleCureus
dc.description.volume15
dc.description.issue9
dc.published.statePublished
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