دورية أكاديمية
Real-World Evaluation of Patiromer for the Treatment of Hyperkalemia in Hemodialysis Patients
| العنوان: | Real-World Evaluation of Patiromer for the Treatment of Hyperkalemia in Hemodialysis Patients |
|---|---|
| المؤلفون: | Csaba P. Kovesdy, Christopher G. Rowan, Ansgar Conrad, David M. Spiegel, Jeanene Fogli, Nina Oestreicher, Jeffrey J. Connaire, Wolfgang C. Winkelmayer |
| المصدر: | Kidney International Reports, Vol 4, Iss 2, Pp 301-309 (2019) |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2019 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | Introduction: Patiromer is a potassium (K+) binding polymer indicated for treating hyperkalemia. Among patients receiving chronic hemodialysis (HD), this study aimed to identify patient characteristics associated with patiromer initiation, describe patiromer utilization, and analyze serum K+ pre- and post-patiromer initiation. Methods: In a retrospective cohort study, using electronic health record data from a large dialysis provider in the United States (study period: December 21, 2015, to December 20, 2016), HD patients were included who had a medication order for patiromer, sodium polystyrene sulfonate (SPS), or laboratory evidence of hyperkalemia (no K+ binder [NoKb] cohort). The index date was the first order for patiromer/SPS, or the first K+ ≥5.0 mEq/l (NoKb cohort), respectively. Using multivariable logistic regression, we identified patient characteristics associated with patiromer initiation. We evaluated patiromer utilization using Kaplan-Meier methodology and proportion of days covered. Serum K+ concentrations were assessed pre- versus post-patiromer initiation. Results: Study cohorts included 527 (patiromer), 852 (SPS), and 8747 (NoKb) HD patients. Median follow-up was 141 days. Patiromer initiators were 2.6 times more likely to have had multiple prior episodes of hyperkalemia (odds ratio [OR]: 2.6; 95% confidence interval [CI]: 1.8–3.7). Most (61%) commenced patiromer on 8.4 g once daily; 60% of patients’ first patiromer order remained open after 180 days. Statistically significant reductions in K+, averaging approximately −0.5 mEq/l, were observed post-patiromer initiation (48% pre-patiromer vs. 22% post-patiromer had K+ ≥6.0 mEq/l [P < 0.001]). Conclusion: Patiromer initiators receiving chronic hemodialysis had comparatively more severe, uncontrolled baseline hyperkalemia. Medication order data show long-term patiromer use was associated with significantly reduced K+. Keywords: hemodialysis, hyperkalemia, patiromer |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2468-0249 |
| العلاقة: | http://www.sciencedirect.com/science/article/pii/S2468024918302912Test; https://doaj.org/toc/2468-0249Test; https://doaj.org/article/2a31e428e71f48d080389241a33b5011Test |
| DOI: | 10.1016/j.ekir.2018.10.020 |
| الإتاحة: | https://doi.org/10.1016/j.ekir.2018.10.020Test https://doaj.org/article/2a31e428e71f48d080389241a33b5011Test |
| رقم الانضمام: | edsbas.5A34F62 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 24680249 |
|---|---|
| DOI: | 10.1016/j.ekir.2018.10.020 |