ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2024
Hyperkalaemia-related reduction of RAASi treatment associates with more subsequent inpatient care.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Interdisciplinary recommendations for recurrent hyperkalaemia: insights from the GUARDIAN-HK European Steering Committee.European heart journal. Cardiovascular pharmacotherapy · 2025Guideline
- Development of a nomogram for predicting hyperkalemia in advanced chronic kidney disease.Renal failure · 2026Article
- Sodium zirconium cyclosilicate post hospital discharge to prevent hyperkalaemia: phase 4, randomized CONTINUITY trial.Clinical kidney journal · 2026Article
- Hyperkalemia management in heart failure and chronic kidney disease: a Spanish cost-effectiveness analysis of patiromer informed by the integrated DIAMOND trial and real-world evidence.BMC health services research · 2026Article
- Safety, effectiveness and treatment patterns of sodium zirconium cyclosilicate for hyperkalemia management in China: actualize study.Frontiers in pharmacology · 2026Article
- Article
- What to do with key cardiovascular drugs when kidney function worsens?Clinical kidney journal · 2026Review
- Rethinking Potassium Management in Chronic Kidney Disease-A Modern Approach.Journal of clinical medicine · 2025Review
- SGLT2 Inhibitors and Risk for Hyperkalemia Among Individuals Receiving RAAS Inhibitors.JAMA internal medicine · 2025Article
- Guideline-Recommended Disease-Modifying Therapies for Patients with Cardiorenal Disease: A Call-to-Action Narrative Review.Advances in therapy · 2025Review
- Duration of sodium zirconium cyclosilicate treatment and continuation of RAASi therapy after a hyperkalaemia episode.ESC heart failure · 2025Observational
- Hyperkalemia management: a multidisciplinary expert panel's perspective on the role of new potassium binders.Heart failure reviews · 2025Review
- Sodium Zirconium Cyclosilicate for Renin-Angiotensin-Aldosterone System Inhibitor Optimization in Patients with Heart Failure with Reduced Ejection Fraction: A Retrospective Analysis.Cardiology and therapy · 2024Article
- Clinical Outcomes in Patients with CKD and Rapid or Non-rapid eGFR Decline: A Report from the DISCOVER CKD Retrospective Cohort.Advances in therapy · 2024Article
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundHyperkalaemia is a barrier to achieving optimal, guideline-directed treatment with renin-angiotensin-aldosterone system inhibitors (RAASis) in patients with chronic kidney disease (CKD) and/or heart failure (HF). This study describes the association between hyperkalaemia-related RAASi treatment reduction and the number of hospitalized days in patients with CKD and/or HF in Sweden and Japan.
methodsUsing data from health registers and hospital medical records, patients with CKD and/or HF currently receiving RAASis who experienced an index hyperkalaemia episode were identified and categorized as having maintained or reduced RAASi treatment post-index; propensity score matching (1:1) was applied to balance the groups in terms of baseline characteristics. Changes in the number of all-cause, CKD- and HF-related hospitalized days per patient-year during 6 months pre- versus post-index and the number of days alive and out of hospital (DAOH) during 6 months post-index were described.
resultsOverall, 20 824 and 7789 patients were included from Sweden and Japan, respectively, 42% and 38% of whom reduced their RAASi treatment after the index hyperkalaemia episode. During the 6 months post-index, all-cause hospitalization increased by 18.2 days [95% confidence interval (CI) 17.0-19.2] per person-year in Sweden and 17.9 days (95% CI 17.4-18.5) per person-year in Japan among patients with reduced RAASi treatment compared with increases of 9.4 days (95% CI 8.6-10.4) and 8.5 days (95% CI 8.0-9.0) per person-year, respectively, among patients with maintained RAASi treatment. The mean DAOH was 121.5 [standard deviation (SD) 75.0] in Sweden and 141.7 (SD 54.5) in Japan among patients with reduced RAASi treatment compared with 154.0 (SD 51.3) and 157.5 (SD 31.6), respectively, among patients with maintained RAASi treatment.
conclusionPatients whose RAASi treatment was reduced after a hyperkalaemia episode had more hospitalized days and fewer DAOH compared with patients whose RAASi treatment was maintained.
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