Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review
Hyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in HD patients. Although the 2015 National Kidney...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Karger Publishers
2021-06-01
|
Series: | Case Reports in Nephrology and Dialysis |
Subjects: | |
Online Access: | https://www.karger.com/Article/FullText/516595 |
id |
doaj-4616265391db4ca3a3d86d1e25f8bcaf |
---|---|
record_format |
Article |
spelling |
doaj-4616265391db4ca3a3d86d1e25f8bcaf2021-07-22T08:10:00ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052021-06-0111215816610.1159/000516595516595Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature ReviewJosé C. De La Flor0https://orcid.org/0000-0001-9346-2279Javier Deira1Alexander Marschall2Francisco Valga3Tania Linares4Tania Monzon5Cristina Albarracín6Elisa Ruiz7Department of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, San Pedro de Alcantara Hospital, Caceres, SpainDepartment of Cardiology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, Doctor Negrín University Hospital, Las Palmas de Gran Canarias, Las Palmas, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Hemodialysis, Avericum S.L., Las Palmas de Gran Canarias, Las Palmas, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainHyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in HD patients. Although the 2015 National Kidney Foundation-Kidney Disease Outcomes Quality Initiate (NKD-KDOQI) guidelines allow the reduction in the weekly HD dose for patients with a residual kidney urea clearance (Kur) >3 mL/min/1.73 m2, very few centers adjust the dialysis dose based on these criteria. In our center, the pattern of incremental hemodialysis (iHD) with once-a-week schedule (1 HD/W) has been an option for a group of patients showing very good results. This pattern is maintained as long as residual diuresis is >1,000 mL/24 h, Kur is >4 mL/min, and there is no presence of edema or volume overload, as well as no analytical parameters persistently outside the advisable range (serum phosphorus >6 mg/dL or potassium [K+] >6.5 mmol/L). Management of hyperkalemia in HD patients includes reduction of dietary intake, dosing of medications that contribute to hyperkalemia, and use of cation-exchange resins such as calcium or sodium polystyrene sulfonate. Two newer potassium binders, patiromer sorbitex calcium and sodium zirconium cyclosilicate, have been safely used for potassium imbalance treatment in patients with ESRD in HD with a conventional regimen of thrice weekly, but has not yet been studied in 1 HD/W schedules. We present the case of a 76-year-old woman in iHD (1 HD/W) treated with patiromer for severe HK and describe her clinical characteristics and outcomes. In addition, we review the corresponding literature. Based on these data, it can be anticipated that the use of patiromer may overcome the risk of hyperkalemia in patients with incident ESRD treated with less-frequent HD regimens.https://www.karger.com/Article/FullText/516595hyperkalemiaincremental hemodialysispatiromer sorbitex calcium |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
José C. De La Flor Javier Deira Alexander Marschall Francisco Valga Tania Linares Tania Monzon Cristina Albarracín Elisa Ruiz |
spellingShingle |
José C. De La Flor Javier Deira Alexander Marschall Francisco Valga Tania Linares Tania Monzon Cristina Albarracín Elisa Ruiz Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review Case Reports in Nephrology and Dialysis hyperkalemia incremental hemodialysis patiromer sorbitex calcium |
author_facet |
José C. De La Flor Javier Deira Alexander Marschall Francisco Valga Tania Linares Tania Monzon Cristina Albarracín Elisa Ruiz |
author_sort |
José C. De La Flor |
title |
Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review |
title_short |
Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review |
title_full |
Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review |
title_fullStr |
Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review |
title_full_unstemmed |
Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review |
title_sort |
patiromer in a patient with severe hyperkalemia on incremental hemodialysis with 1 session per week: a case report and literature review |
publisher |
Karger Publishers |
series |
Case Reports in Nephrology and Dialysis |
issn |
2296-9705 |
publishDate |
2021-06-01 |
description |
Hyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in HD patients. Although the 2015 National Kidney Foundation-Kidney Disease Outcomes Quality Initiate (NKD-KDOQI) guidelines allow the reduction in the weekly HD dose for patients with a residual kidney urea clearance (Kur) >3 mL/min/1.73 m2, very few centers adjust the dialysis dose based on these criteria. In our center, the pattern of incremental hemodialysis (iHD) with once-a-week schedule (1 HD/W) has been an option for a group of patients showing very good results. This pattern is maintained as long as residual diuresis is >1,000 mL/24 h, Kur is >4 mL/min, and there is no presence of edema or volume overload, as well as no analytical parameters persistently outside the advisable range (serum phosphorus >6 mg/dL or potassium [K+] >6.5 mmol/L). Management of hyperkalemia in HD patients includes reduction of dietary intake, dosing of medications that contribute to hyperkalemia, and use of cation-exchange resins such as calcium or sodium polystyrene sulfonate. Two newer potassium binders, patiromer sorbitex calcium and sodium zirconium cyclosilicate, have been safely used for potassium imbalance treatment in patients with ESRD in HD with a conventional regimen of thrice weekly, but has not yet been studied in 1 HD/W schedules. We present the case of a 76-year-old woman in iHD (1 HD/W) treated with patiromer for severe HK and describe her clinical characteristics and outcomes. In addition, we review the corresponding literature. Based on these data, it can be anticipated that the use of patiromer may overcome the risk of hyperkalemia in patients with incident ESRD treated with less-frequent HD regimens. |
topic |
hyperkalemia incremental hemodialysis patiromer sorbitex calcium |
url |
https://www.karger.com/Article/FullText/516595 |
work_keys_str_mv |
AT josecdelaflor patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT javierdeira patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT alexandermarschall patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT franciscovalga patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT tanialinares patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT taniamonzon patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT cristinaalbarracin patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview AT elisaruiz patiromerinapatientwithseverehyperkalemiaonincrementalhemodialysiswith1sessionperweekacasereportandliteraturereview |
_version_ |
1721291627771723776 |