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The opposing view is that sodium polystyrene sulfonate remains effective, familiar, inexpensive, and often well tolerated, while direct comparative evidence has not yet shown clinically meaningful superiority of newer binders. This debate weighs clinical utility, comparative efficacy, safety, and cost, concluding that new binders are valuable options but that their routine replacement of established low-dose sodium polystyrene sulfonate and the need for potassium binders beyond optimized diuretic therapy, acidosis control, diet, etc. requires stronger comparative evidence.<\/jats:p>","DOI":"10.1093\/ckj\/sfag360","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:53:28Z","timestamp":1791374008000},"source":"Crossref","is-referenced-by-count":0,"title":["New potassium binders: we need them\u2014we do not need them"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-0182","authenticated-orcid":false,"given":"Luca","family":"De\u00a0Nicola","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Department of Advanced Medical and Surgical Sciences, University L. Vanvitelli , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Clinical Intervention and Technology, Karolinska Institute and Karolinska University Hospital , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Floege","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology, RWTH Aachen University Hospital , Aachen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Zoccali","sequence":"additional","affiliation":[{"name":"Associazione Ipertensione, Nefrologia, Trapianto Renale (IPNET) , Reggio Calabria ,","place":["Italy"]},{"name":"Institute of Biology and Molecular Genetics , Ariano Irpino ,","place":["Italy"]},{"name":"Renal Research Institute , NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026101603381842700_bib1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes KDIGO CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2026101603381842700_bib2","doi-asserted-by":"publisher","first-page":"1824","DOI":"10.34067\/KID.0000000000000541","article-title":"Hyperkalemia and risk of CKD progression: a propensity score-matched analysis","volume-title":"Kidney360","author":"Agiro","year":"2024"},{"key":"2026101603381842700_bib3","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1053\/j.ajkd.2022.01.002","article-title":"Hyperkalemia-related discontinuation of renin-angiotensin-aldosterone system inhibitors and clinical outcomes in CKD: a population-based cohort study","volume":"80","author":"Leon","year":"2022","journal-title":"Am J Kidney Dis"},{"key":"2026101603381842700_bib4","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1002\/ejhf.1793","article-title":"Heart Failure Long-Term Registry Investigators Group. 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