Unknown

Dataset Information

0

Real-World Evaluation of Patiromer for the Treatment of Hyperkalemia in Hemodialysis Patients.


ABSTRACT:

Introduction

Patiromer is a potassium (K+) binding polymer indicated for treating hyperkalemia. Among patients receiving chronic hemodialysis (HD), this study aimed to identify patient characteristics associated with patiromer initiation, describe patiromer utilization, and analyze serum K+ pre- and post-patiromer initiation.

Methods

In a retrospective cohort study, using electronic health record data from a large dialysis provider in the United States (study period: December 21, 2015, to December 20, 2016), HD patients were included who had a medication order for patiromer, sodium polystyrene sulfonate (SPS), or laboratory evidence of hyperkalemia (no K+ binder [NoKb] cohort). The index date was the first order for patiromer/SPS, or the first K+ ?5.0 mEq/l (NoKb cohort), respectively. Using multivariable logistic regression, we identified patient characteristics associated with patiromer initiation. We evaluated patiromer utilization using Kaplan-Meier methodology and proportion of days covered. Serum K+ concentrations were assessed pre- versus post-patiromer initiation.

Results

Study cohorts included 527 (patiromer), 852 (SPS), and 8747 (NoKb) HD patients. Median follow-up was 141 days. Patiromer initiators were 2.6 times more likely to have had multiple prior episodes of hyperkalemia (odds ratio [OR]: 2.6; 95% confidence interval [CI]: 1.8-3.7). Most (61%) commenced patiromer on 8.4 g once daily; 60% of patients' first patiromer order remained open after 180 days. Statistically significant reductions in K+, averaging approximately -0.5 mEq/l, were observed post-patiromer initiation (48% pre-patiromer vs. 22% post-patiromer had K+ ?6.0 mEq/l [P < 0.001]).

Conclusion

Patiromer initiators receiving chronic hemodialysis had comparatively more severe, uncontrolled baseline hyperkalemia. Medication order data show long-term patiromer use was associated with significantly reduced K+.

SUBMITTER: Kovesdy CP 

PROVIDER: S-EPMC6365398 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

altmetric image

Publications

Real-World Evaluation of Patiromer for the Treatment of Hyperkalemia in Hemodialysis Patients.

Kovesdy Csaba P CP   Rowan Christopher G CG   Conrad Ansgar A   Spiegel David M DM   Fogli Jeanene J   Oestreicher Nina N   Connaire Jeffrey J JJ   Winkelmayer Wolfgang C WC  

Kidney international reports 20181029 2


<h4>Introduction</h4>Patiromer is a potassium (K<sup>+</sup>) binding polymer indicated for treating hyperkalemia. Among patients receiving chronic hemodialysis (HD), this study aimed to identify patient characteristics associated with patiromer initiation, describe patiromer utilization, and analyze serum K<sup>+</sup> pre- and post-patiromer initiation.<h4>Methods</h4>In a retrospective cohort study, using electronic health record data from a large dialysis provider in the United States (study  ...[more]

Similar Datasets

| S-EPMC9292454 | biostudies-literature
| S-EPMC9310460 | biostudies-literature
| S-EPMC6734103 | biostudies-literature
| S-EPMC7414716 | biostudies-literature
| S-EPMC8326359 | biostudies-literature
| S-EPMC6244629 | biostudies-literature
| S-EPMC4678168 | biostudies-literature
| S-EPMC5414516 | biostudies-literature
| S-EPMC5388568 | biostudies-literature
| S-EPMC8640539 | biostudies-literature