ArticleBMC nephrology2026
Real-world effectiveness of patiromer among hemodialysis patients: a one-year retrospective cohort study.
Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHyperkalemia is a common and potentially life-threatening complication among patients receiving maintenance hemodialysis (HD). Patiromer (Veltassa
methodsWe conducted a retrospective, single-arm, cohort study of adult patients (n = 10,860) receiving in-center HD at Fresenius Kidney Care clinics who initiated patiromer between 2016 and 2022, comparing outcomes before (baseline: 3 months prior to initiation) and after initiation (up to 12 months of follow-up). Outcomes included changes in serum potassium (sK), treatment schedules, dosing patterns, and hospitalizations.
resultsAt baseline, mean age was 60 years, 58% were male, and mean sK was 5.60 ± 0.56 mEq/L. Following patiromer initiation, the proportion of patients achieving sK < 5.5 mEq/L increased from 35.6% to 69.9%. Mean sK decreased to 5.30 mEq/L at quarter 1 (Q1) and remained stable through Q4 (5.21 mEq/L). Mean sK reductions at Q4 were - 0.40, - 0.30, and - 0.21 mEq/L for patiromer doses of 8.4 g, 16.8 g, and 25.2 g once daily, respectively. Patiromer was most commonly prescribed once daily (55.9%) at 8.4 g (91.2%), and dose titrations were infrequent. Use of 1 mEq/L potassium dialysate declined from 17.2% to 11.0%. From baseline to 12 months, all-cause hospitalization rate decreased from 1.77 to 1.68 events per person-year (p = 0.004), while hyperkalemia-related hospitalizations declined from 0.35 to 0.20 (p < 0.0001). Serum calcium, sodium, phosphorus, and magnesium remained stable.
conclusionsIn this large real-world cohort, lower serum potassium levels were observed following patiromer initiation over 12 months, along with stable electrolyte profiles and a low need for dose adjustments. Reductions in hospitalization rates were also observed over time but should be interpreted cautiously given the single-arm, retrospective design without a control group. These findings support the clinical utility of patiromer for chronic hyperkalemia management in HD patients.
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