Risk factors for hyperkalemia include cardiovascular and renal conditions as well as diabetes and use of RAAS inhibitors2

Hyperkalemia, a condition in which the serum potassium (K+) level exceeds 5.0 mEq/L, occurs more commonly in patients with chronic kidney disease, heart failure, and diabetes because of the underlying pathophysiology of those conditions.2,3

Sample patient presentations include the following:

 

PATIENT WITH TYPE 2 DIABETES

  • Has had 2 occurrences of hyperkalemia in 1 year
  • Receiving RAAS inhibitor therapy
  • Currently presenting with hyperkalemia
 
 

PATIENT WITH HEART FAILURE

  • Has had 2 occurrences of hyperkalemia in 18 months
  • Receiving dual RAAS inhibitor therapy
  • Currently presenting with hyperkalemia
 
 

PATIENT WITH STAGE 4 CKD

  • Has had 3 occurrences of hyperkalemia in 1 year
  • Taking a loop diuretic
  • Currently presenting with hyperkalemia
 
 

In addition, use of renin-angiotensin-aldosterone system (RAAS) inhibitors can increase both the frequency and severity of hyperkalemia. Aldosterone-receptor antagonists, angiotensin-receptor blockers, and direct renin inhibitors, among other RAAS inhibitor therapies, have been shown to have this effect.2

CKD=chronic kidney disease.

Hyperkalemia can be recurrent for many patients3,4

In one study (The Truven MarketScan® analysis), 40% of patients with hyperkalemia experienced 2 or more hyperkalemic events during the 1-year, post-index period.3

Risk factors for Hyperkalemia Risk factors for Hyperkalemia

4 in 10

patients (n=15,693) had ≥2 hyperkalemia events

60.4% of patients (n=23,933) had 1 hyperkalemia event

15.6% of patients (n=6180) had ≥3 hyperkalemia events

8.2% of patients (n=3234) had ≥4 hyperkalemia events

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 K+ 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.3

LOKELMA helps reduce serum potassium levels and maintain normokalemia with continued therapy in patients treated for hyperkalemia.8

 

Reducing or discontinuing RAAS inhibitor therapy to manage hyperkalemia may compromise guideline-recommended treatment1

Despite guideline recommendations*, RAAS inhibitor treatment was frequently reduced or discontinued to manage hyperkalemia.1

 

In one study, almost 50% of patients who experienced a moderate-to-severe hyperkalemia event had their RAAS inhibitor stopped or reduced.1

 

In an analysis from the Humedica database of health records, medical data were analyzed for 66,862 patients with hyperkalemia. 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 were excluded.1

*The American Diabetes Association, KDIGO, and the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines/Heart Failure Society of America, all recommend RAAS inhibitor therapy for patients with diabetes, CKD, and HF, respectively.5-7

Moderate-to-severe hyperkalemia was defined as serum K+ ≥5.5 mEq/L.1

CKD=chronic kidney disease; HF=heart failure; KDIGO=Kidney Disease, Improving Global Outcomes; RAAS=renin-angiotensin-aldosterone system; SPS=sodium polystyrene sulfonate.

Treatment options that remove potassium from the body can be important for treating hyperkalemia.

Choose LOKELMA in any setting for your adult patients with hyperkalemia.8

LOKELMA does not replace temporizing agents for the emergency treatment of life-threatening hyperkalemia. With LOKELMA, there are no contraindications or drug interactions with temporizing agents listed in the Prescribing Information. LOKELMA can be used to treat hyperkalemia in adults in the emergency department, but should not be used as an emergency treatment for life-threatening hyperkalemia due to its delayed onset of action.8

Learn about this innovative treatment option

IMPORTANT SAFETY INFORMATION FOR LOKELMA® (sodium zirconium cyclosilicate) 10 g FOR ORAL SUSPENSION

WARNINGS AND PRECAUTIONS:

  • Gastrointestinal Adverse Events in Patients with Motility Disorders: Avoid LOKELMA in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders. LOKELMA has not been studied in patients with these conditions and it may be ineffective and may worsen gastrointestinal conditions
  • Edema: Each 5 g dose of LOKELMA contains approximately 400 mg of sodium. In clinical trials of LOKELMA, edema was generally mild to moderate in severity and was more commonly seen in patients treated with 15 g once daily. Monitor for signs of edema, particularly in patients who should restrict their sodium intake or are prone to fluid overload (eg., heart failure or renal disease). Advise patients to adjust dietary sodium, if appropriate. Increase the dose of diuretics as needed

ADVERSE REACTIONS: The most common adverse reaction with LOKELMA was mild to moderate edema. In placebo-controlled trials up to 28 days, edema was reported in 4.4%, 5.9%, 16.1% of patients treated with 5 g, 10 g and 15 g of LOKELMA once daily, respectively vs 2.4% of patients receiving placebo.

DRUG INTERACTIONS: LOKELMA can transiently increase gastric pH. In general, oral medications with pH-dependent solubility should be administered at least 2 hours before or 2 hours after LOKELMA. Spacing is not needed if it has been determined the concomitant medication does not exhibit pH-dependent solubility.

INDICATION AND LIMITATION OF USE

LOKELMA is indicated for the treatment of hyperkalemia in adults.

LOKELMA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

Please see full Prescribing Information for LOKELMA.

IMPORTANT SAFETY INFORMATION FOR LOKELMA® (sodium zirconium cyclosilicate) 10 g FOR ORAL SUSPENSION

WARNINGS AND PRECAUTIONS:

  • Gastrointestinal Adverse Events in Patients with Motility Disorders: Avoid LOKELMA in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders. LOKELMA has not been studied in patients with these conditions and it may be ineffective and may worsen gastrointestinal conditions
  • Edema: Each 5 g dose of LOKELMA contains approximately 400 mg of sodium. In clinical trials of LOKELMA, edema was generally mild to moderate in severity and was more commonly seen in patients treated with 15 g once daily. Monitor for signs of edema, particularly in patients who should restrict their sodium intake or are prone to fluid overload (eg., heart failure or renal disease). Advise patients to adjust dietary sodium, if appropriate. Increase the dose of diuretics as needed

ADVERSE REACTIONS: The most common adverse reaction with LOKELMA was mild to moderate edema. In placebo-controlled trials up to 28 days, edema was reported in 4.4%, 5.9%, 16.1% of patients treated with 5 g, 10 g and 15 g of LOKELMA once daily, respectively vs 2.4% of patients receiving placebo.

DRUG INTERACTIONS: LOKELMA can transiently increase gastric pH. In general, oral medications with pH-dependent solubility should be administered at least 2 hours before or 2 hours after LOKELMA. Spacing is not needed if it has been determined the concomitant medication does not exhibit pH-dependent solubility.

INDICATION AND LIMITATION OF USE

LOKELMA is indicated for the treatment of hyperkalemia in adults.

LOKELMA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

Please see full Prescribing Information for LOKELMA.