ArticleBMC nephrology2019
The value of maintaining normokalaemia and enabling RAASi therapy in chronic kidney disease.
Article in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials.Frontiers in medicine · 2021Pooled it
- Development of a nomogram for predicting hyperkalemia in advanced chronic kidney disease.Renal failure · 2026Article
- The burden of hyperkalaemia in chronic kidney disease: a systematic literature review.Clinical kidney journal · 2025Article
- Frequency of hyperkalemia during optimization of guideline-directed medical therapy in ambulatory patients with HFrEF.Frontiers in cardiovascular medicine · 2025Article
- Management of hyperkalemia: Expert consensus from Kuwait - a Modified Delphi Approach.International journal of nephrology and renovascular disease · 2024Article
- Sodium polystyrene is unsafe and should not be prescribed for the treatment of hyperkalaemia:Clinical kidney journal · 2023Article
- Pharmacological strategies to manage hyperkalaemia: out with the old, in with the new? Not so fast….Clinical kidney journal · 2023Article
- A cost-effectiveness analysis of patiromer in the UK: evaluation of hyperkalaemia treatment and lifelong RAASi maintenance in chronic kidney disease patients with and without heart failure.BMC nephrology · 2023Article
- Cost effectiveness of sodium zirconium cyclosilicate for the treatment of hyperkalaemia in patients with CKD in Norway and Sweden.BMC nephrology · 2022Article
- Association between hyperkalemia, RAASi non-adherence and outcomes in chronic kidney disease.Journal of nephrology · 2022Observational
- Challenging patient phenotypes in the management of anaemia of chronic kidney disease.International journal of clinical practice · 2021Review
- Chronic kidney disease progression among patients with type 2 diabetes identified in US administrative claims: a population cohort study.Clinical kidney journal · 2021Article
- Renin-angiotensin system blockade in patients with chronic kidney disease: benefits, problems in everyday clinical use, and open questions for advanced renal dysfunction.Journal of human hypertension · 2021Review
- Association between serum potassium levels and adverse outcomes in chronic kidney disease: the Fukushima CKD cohort study.Clinical and experimental nephrology · 2021Article
- Hyperkalemia Among Hospitalized Patients and Association Between Duration of Hyperkalemia and Outcomes.Cureus · 2020Article
- Real-World Associations Between Renin-Angiotensin-Aldosterone System Inhibition Therapy, Hyperkalemia, and Outcomes: A Clinical and Scientific Call to Action.Journal of the American Heart Association · 2019Article
- [Austrian Consensus on High Blood Pressure 2019].Wiener klinische Wochenschrift · 2019Article
- Clinical and Economic Burden of Hyperkalemia: A Nationwide Hospital-Based Cohort Study in Japan.Kidney medicineArticle
Corrections and comments
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Authors and funding
8 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople with chronic kidney disease (CKD) are at an increased risk of developing hyperkalaemia due to their declining kidney function. In addition, these patients are often required to reduce or discontinue guideline-recommended renin-angiotensin-aldosterone system inhibitor (RAASi) therapy due to increased risk of hyperkalaemia. This original research developed a model to quantify the health and economic benefits of maintaining normokalaemia and enabling optimal RAASi therapy in patients with CKD.
methodsA patient-level simulation model was designed to fully characterise the natural history of CKD over a lifetime horizon, and predict the associations between serum potassium levels, RAASi use and long-term outcomes based on published literature. The clinical and economic benefits of maintaining sustained potassium levels and therefore avoiding RAASi discontinuation in CKD patients were demonstrated using illustrative, sensitivity and scenario analyses.
resultsInternal and external validation exercises confirmed the predictive capability of the model. Sustained potassium management and ongoing RAASi therapy were associated with longer life expectancy (+ 2.36 years), delayed onset of end stage renal disease (+ 5.4 years), quality-adjusted life-year gains (+ 1.02 QALYs), cost savings (£3135) and associated net monetary benefit (£23,446 at £20,000 per QALY gained) compared to an absence of RAASi to prevent hyperkalaemia.
conclusionThis model represents a novel approach to predicting the long-term benefits of maintaining normokalaemia and enabling optimal RAASi therapy in patients with CKD, irrespective of the strategy used to achieve this target, which may support decision making in healthcare.
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