Evidence map›Paper›PMID 40032388›Full record

ArticleBMJ open2025

Non-inferiority of sodium zirconium cyclosilicate versus potassium-restricted diet in achieving normokalaemia in patients with type 2 diabetes mellitus: protocol for a multicentre, open-label, randomised controlled, two-arm clinical trial (SILVERSTAR study).

Junya Hironaka, Hiroshi Okada, Takafumi Osaka, Yoshitaka Hashimoto, Genki Kobayashi, Muhei Tanaka, Akinori Kogure, Kazuteru Mitsuhashi, Takashi Yoshimura, Noriyuki Kitagawa and 14 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Junya HironakaDepartment of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan.ORCID http://orcid.org/0000-0002-2970-5333
Hiroshi OkadaDepartment of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan.ORCID http://orcid.org/0000-0002-1707-970X
Takafumi OsakaAyabe City Hospital, Ayabe, Japan.
Yoshitaka HashimotoMatsushita Memorial Hospital, Moriguchi, Japan.ORCID http://orcid.org/0000-0002-8794-0550
Genki KobayashiAiseikai Ymashina Hospital, Kyoto, Japan.
Muhei TanakaShiritsu Suita Shimin Byoin, Suita, Japan.
Akinori KogureDepartment of Diabetes and Metabolic Medicine, Kyoto City Hospital, Kyoto, Japan.
Kazuteru MitsuhashiDepartment of Diabetes Internal Medicine, Fukuchiyama City Hospital, Fukuchiyama, Japan.
Takashi YoshimuraAkashi City Hospital, Akashi, Japan.
Noriyuki KitagawaDepartment of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan.ORCID http://orcid.org/0000-0003-3263-9469
Miho YanoDepartment of Diabetology, Nishijin Hospital, Kyoto, Japan.
Akane KitamuraDepartment of Diabetology, Nagitsuji Hospital, Kyoto, Japan.
Akio KishiDepartment of Diabetes, Kyoto Okamoto Memorial Hospital, Kuze-gun, Japan.
Takeshi TsutsumiKyoto Yamashiro General Medical Center, Kizugawa, Japan.
Masahiro YamazakiKyoto Second Red Cross Hospital, Kyoto, Japan.
Michiyo IshiiDepartment of Internal Medicine, Otsu City Hospital, Otsu, Japan.
Shinichi MogamiDepartment of Endocrinology, Metabolism, and Diabetes, Saiseikai Suita Hospital, Osaka, Japan.
Naoto NakamuraKyoto Saiseikai Hospital, Nagaokakyo, Japan.
Takuya FukudaAmanogawa Hospital, Kishiwada, Japan.
Toru TanakaJapanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
Ryo BambaKyoto Chubu Medical Center, Nantan, Japan.
Eiko SatoAshikaga University, Ashikaga, Japan.
Masahide HamaguchiDepartment of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan mhama@koto.kpu-m.ac.jp.ORCID http://orcid.org/0000-0002-8651-4445
Michiaki FukuiDepartment of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan.ORCID http://orcid.org/0000-0003-0903-1797

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo effectively manage the progression of diabetic kidney disease, it is essential to address the associated hyperkalaemia while concurrently using renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists. In this study, we aim to evaluate the effects of administering sodium zirconium cyclosilicate (SZC) to patients with type 2 diabetes mellitus (T2DM) complicated by hyperkalaemia. METHODS AND ANALYSIS: A total of 80 patients with type 2 diabetes and hyperkalaemia will be included in the study and randomly stratified into two groups.After consent, both groups will enter an initiation phase, receiving 10 g of SZC, three times per day for 2 days. SZC administration (5 g once daily) will subsequently commence in group A, while dietary therapy will be initiated in group B by implementing a potassium-restricted diet. The primary endpoint of the study is the proportion of normokalaemic (3.5 mEq/L≤serum potassium (sK)<5.0 mEq/L) participants at visit 7. The secondary endpoints are: (a) the proportion of normokalaemic participants (3.5 mEq/L≤sK<5.0 mEq/L) at visit 4 and (b) serum potassium levels at visit 7. ETHICS AND DISSEMINATION: Written informed consent will be obtained from all participants prior to commencing the study. This study has been approved by the Kyoto Prefectural University of Medicine Clinical Research Review Board. All data obtained from this study will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: jRCTs051230067.

Indexed as

Diabetes Mellitus, Type 2HyperkalemiaPotassiumPotassium, DietarySilicatesAdultAgedDiabetic NephropathiesEquivalence Trials as TopicFemaleHumansMaleMiddle AgedMulticenter Studies as TopicRandomized Controlled Trials as TopicPotassiumPotassium, DietarySilicatessodium zirconium cyclosilicateChronic renal failureDiabetes Mellitus, Type 2Randomised Controlled Trial

Identifiers

PMID40032388
PMCPMC11877247

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.