Managing hyperkalemia can be challenging for
you and your patients1

Hyperkalemia can be a recurrent condition and poses an increased risk of mortality2,3

40% of patients with hyperkalemia experienced 2 or more hyperkalemic events during the 1 year post-index period
40% of patients with hyperkalemia experienced 2 or more hyperkalemic events during the 1 year post-index period
40% of patients with hyperkalemia experienced 2 or more hyperkalemic events during the 1-year post-index period*2
  • 15.6% of patients (n=6180) experienced ≥3 hyperkalemic events2
  • 8.2% of patients (n=3234) experienced ≥4 hyperkalemic events2

In a study of almost 1 million patients, hyperkalemia was an independent risk factor for all-cause mortality†3

Predicted probability of mortality with hyperkalemia as an independent risk factor.
Predicted probability of mortality with hyperkalemia as an independent risk factor.
LOKELMA® (sodium zirconium cyclosilicate) is not indicated to reduce the risk of death.4

Serum K+ ≥5.0 mEq/L was associated with an increased risk of all-cause mortality in patients with CKD, HF, diabetes, all 3, or none of these comorbidities.3

  • Even mild hyperkalemia (5.0-<5.5 mEq/L) was associated with increased all-cause mortality over an average 18-month follow-up3

*Based on a retrospective analysis of a medical claims database with 39,626 matched pairs of patients with or without hyperkalemia. Patients with hyperkalemia were defined as having 2 laboratory tests with a serum potassium level >5.0 mEq/L, at least 1 diagnosis code corresponding to hyperkalemia (ICD-9 code: 276.7), or at least 1 prescription fill of SPS.5

Retrospective study of 911,698 patients from multiple integrated health delivery networks (Humedica). Control group included 338,297 individuals without known HF, CKD, diabetes, cardiovascular disease, or hypertension. Patient data came from private insurers, Medicare and Medicaid users, and uninsured individuals.3

CKD=chronic kidney disease; HF=heart failure; SPS=sodium polystyrene sulfonate.

Reducing or discontinuing RAAS inhibitor therapy may not be optimal for your patients*6

KDIGO 2020 guidelines for diabetes management in chronic kidney disease states.
KDIGO 2020 guidelines for diabetes management in chronic kidney disease states.

THE KDIGO 2020 GUIDELINE FOR DIABETES MANAGEMENT IN CHRONIC KIDNEY DISEASE STATES7:

  • In patients with diabetes, hypertension, and albuminuria, ACEi or ARB treatment should be initiated and titrated to the maximum approved dose that is tolerated7
  • ACEi or ARB treatment should only be reduced or discontinued if serum K+ levels cannot be otherwise managed or if there is a greater than 30% increase in serum creatinine.7
  • Recommendations to manage hyperkalemia include review concurrent drugs, moderate K+ intake, initiate diuretics or oral sodium bicarbonate in appropriate patients, and use of a gastrointestinal cation exchanger such as a K+ binder7
  • K+ binders should be considered to decrease serum K+ levels after other measures have failed, rather than decreasing or discontinuing ACEi or ARB treatment7

Learn more about the KDIGO 2020 Guideline for Diabetes Management in CKD

REVIEW

Mortality was at least 2x higher
Mortality was at least 2x higher

MORTALITY WAS AT LEAST 2x HIGHER

for CKD patients whose RAAS inhibitor had been reduced or discontinued, compared to patients on maximum RAAS inhibitor doses.*6

Patients consuming a heart-healthy, plant-based diet may not need additional dietary restrictions when using K+ binders for the treatment of hyperkalemia8

Healthy diet
Healthy diet
  • Recent clinical studies have shown the efficacy of using K+ binders for the treatment of hyperkalemia8
  • Some of these studies did not impose dietary restrictions during potassium-binder therapy, indicating that K+ binders may remain effective in patients who consume this type of diet8

*Based on data from an analysis of medical records for 66,862 patients with hyperkalemia from the Humedica database. Patients with at least 1 outpatient RAAS inhibitor prescription were included in the 12-month analysis. Patients with end-stage renal disease, CKD stage 5, and acute kidney injury at the index date were excluded. Mortality rates during the 12-month period were 4.1% for patients on maximum RAAS inhibitor dose, 8.2% for patients on submaximum dose, and 11.0% for patients who discontinued RAAS inhibitor therapy.6

Hyperkalemia was defined as serum K+ >5.0 mEq/L.6

Patients were categorized by their last RAAS inhibitor dose level for the analysis of mortality. Maximum was defined as the labeled dose and submaximum was defined as any dose lower than the labeled dose.6

ACEi=angiotensin-converting enzyme inhibitor; ARB=angiotensin II receptor blocker; CKD=chronic kidney disease; RAAS=renin-angiotensin-aldosterone system.

Discover how LOKELMA may help your patients maintain RAAS inhibitor use