{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:03:34Z","timestamp":1792728214566,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi) are guideline\u2010recommended therapy for individuals with cardiorenal disease. They are associated with increased risk of hyperkalaemia, a common and life\u2010threatening disorder for this population. RAASi\u2010induced hyperkalaemia often leads to dose reduction or discontinuation, reducing cardiorenal protection. Guideline recommendations differ between specialties for the clinical management of hyperkalaemia. Using a modified Delphi method, we developed consensus recommendations for optimal management of hyperkalaemia in adults with cardiorenal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      An international steering group of cardiologists and nephrologists developed 39 statements regarding hyperkalaemia care, including risk factors and risk stratification, prevention, correction, and cross\u2010specialty coordination. Consensus was determined by agreement on an online questionnaire administered to cardiorenal specialists across Europe and North America. The threshold for consensus agreement was established a priori by the steering group at 67%. Across November 2021, 520 responses were received from Canada (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a050), France (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a050), Germany (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a054), Italy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a058), Spain (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a057), the UK (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a049), and the US (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0202); 268 from cardiologists and 252 from nephrologists. Twenty\u2010nine statements attained very high agreement (\u226590%) and 10 attained high agreement (\u226567%\u2013&lt;90%), with strong alignment between cardiologists and nephrologists.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high degree of consensus regarding hyperkalaemia evaluation and management exists among healthcare professionals. Based on high levels of agreement, the steering group derived six key recommendations for hyperkalaemia prevention and management in people with cardiorenal disease. Future studies examining the quality of hyperkalaemia care delivery are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2612","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:19:45Z","timestamp":1657066785000},"page":"1467-1477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["An international Delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1176-7592","authenticated-orcid":false,"given":"James O.","family":"Burton","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"Monash University Australia and the University of Warwick Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba P.","family":"Kovesdy","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biff F.","family":"Palmer","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana L.","family":"Pi\u00f1a","sequence":"additional","affiliation":[{"name":"Central Michigan University Mount Pleasant MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rosano","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Roma Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish M.","family":"Sood","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Zieroth","sequence":"additional","affiliation":[{"name":"University of Manitoba Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01730215"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_2_9_4_1","article-title":"Clinical Practice Guideline","author":"Renal Association","year":"2020","journal-title":"Treatment of acute hyperkalaemia in adults"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz225"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.02.022"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100739"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2019.8.2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.06.019"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.11.003"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.08.022"},{"key":"e_1_2_9_13_1","first-page":"S212","article-title":"Evaluation of the treatment gap between clinical guidelines and the utilization of renin\u2010angiotensin\u2010aldosterone system inhibitors","volume":"21","author":"Epstein M","year":"2015","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1199"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvy015"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32484-X"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2020.03.037"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"Rossignol P Lainscak M Crespo\u2010Leiro MG Laroche C Piepoli MF Filippatos G et al.; Heart Failure Long\u2010Term Registry Investigators Group. 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Data from 9222 chronic heart failure patients of the ESC\u2010HFA\u2010EORP Heart Failure Long\u2010Term Registry.Eur J Heart Fail. 2020;22:1378\u201389.","DOI":"10.1002\/ejhf.1793"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004675"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.04.019"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12265"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411487"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4212\/cjhp.v68i4.1469"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08360621"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32135-X"},{"key":"e_1_2_9_26_1","unstructured":"ClinicalTrials.gov.NCT03888066: Patiromer for the management of hyperkalemia in subjects receiving RAASi medications for the treatment of heart failure (DIAMOND).2019.https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT03888066(3 February 2022)."},{"key":"e_1_2_9_27_1","unstructured":"ClinicalTrials.gov.NCT05056727: A study to evaluate the effect of sodium zirconium cyclosilicate on chronic kidney disease (CKD) progression in participants with CKD and hyperkalaemia or at risk of hyperkalaemia (STABILIZE\u2010CKD).2021.https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT05056727. 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