{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:23:35Z","timestamp":1745468615284,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"5-6","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiorenal Med"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>Background: Renin-angiotensin-aldosterone system inhibitors (RAASi) improve prognosis in patients with heart failure with reduced ejection fraction (HFrEF), but suboptimal dosing or discontinuation of these medications often occurs due to RAASi-associated hyperkalaemia. We established a nephrology-led hyperkalaemia clinic to oversee prescribing of patiromer, an oral potassium binder, to facilitate RAASi optimization. Methods: The clinic was established in July 2019 at a nephrology tertiary centre in the UK. Patients with HFrEF who were unable to increase RAASi dosage due to hyperkalaemia were referred to the clinic, where all patients commenced patiromer 8.4 g daily. RAASi adjustments were deferred to the referring teams. Study outcomes included the percentage of patients who achieved a RAASi dose increase and the proportion of patients with normokalaemia at follow-up. Outcomes were evaluated until 1 May 2021. Results: A total of 34 patients were reviewed in the clinic between July 2019 and December 2020. Mean age was 71.6 years (\u00b110.6 years), 56% had diabetes, and 71% had chronic kidney disease stages 3a-5; mean estimated glomerular filtration rate was 56 mL\/min\/1.73 m2 (\u00b121 mL\/min\/1.73 m2). During follow-up, 13 patients discontinued patiromer (6 of whom did so due to gastrointestinal side effects) and were discharged; 2 patients died from non-hyperkalaemia-related illness; one switched to an alternative potassium binder. Over a mean follow-up of 13.4 months (\u00b15.8 months), 17 of the 20 patients (85%) who continued with a potassium binder achieved a RAASi dose increase, with 4 patients (20%) receiving maximal dosages. This was attained by achieving normokalaemia during follow-up. No patients required magnesium supplementation. Of the 19 patients on patiromer, 12 continued this therapy for more than 12 months and 4 received it safely for 20 months. Discussion\/Conclusion: Patiromer prescribing in a nephrology-led hyperkalaemia clinic facilitated RAASi up-titration in patients with HFrEF by controlling potassium levels. <\/jats:p>","DOI":"10.1159\/000526106","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T21:00:31Z","timestamp":1661979631000},"page":"196-204","source":"Crossref","is-referenced-by-count":2,"title":["Experience of a Bespoke Hyperkalaemia Clinic to Facilitate Prescribing of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Heart Failure with Reduced Ejection Fraction"],"prefix":"10.1159","volume":"12","author":[{"given":"Ibrahim","family":"Ali","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren","family":"Green","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kalra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip A.","family":"Kalra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2022,8,31]]},"container-title":["Cardiorenal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/crm\/article\/12\/5-6\/196\/841746\/Experience-of-a-Bespoke-Hyperkalaemia-Clinic-to","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/crm\/article\/12\/5-6\/196\/841746\/Experience-of-a-Bespoke-Hyperkalaemia-Clinic-to","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:12:44Z","timestamp":1745421164000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000526106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":0,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2023,1,30]]}},"URL":"https:\/\/doi.org\/10.1159\/000526106","archive":["Portico"],"relation":{},"ISSN":["1664-3828","1664-5502"],"issn-type":[{"type":"print","value":"1664-3828"},{"type":"electronic","value":"1664-5502"}],"subject":[],"published":{"date-parts":[[2022]]}}}