{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:46:19Z","timestamp":1791996379705,"version":"4.4.0"},"reference-count":18,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"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":["Kidney Dis"],"abstract":"<jats:p>Introduction: Chronic hyperkalemia in patients with chronic kidney disease (CKD) often limits the use of vital renin-angiotensin-aldosterone system inhibitors (RAASi). Methods: This prospective cohort study compared the efficacy and safety of patiromer (n = 40) versus sodium polystyrene sulfonate (SPS) (n = 40) for chronic hyperkalemia management in 80 adult CKD patients. Results: Over a 6-month follow-up, both agents effectively reduced serum potassium from similar baseline levels (patiromer: 5.73 \u00b1 0.59 mmol\/L; SPS: 5.62 \u00b1 0.50 mmol\/L) with no significant difference in efficacy (p &gt; 0.05). However, key differences in the clinical impact on RAASi therapy emerged, alongside numerical but statistically nonsignificant differences in tolerability. Patients receiving patiromer had a significantly lower rate of RAASi therapy discontinuation compared to the SPS group (5.2% vs. 36.3%; p = 0.033), enabling continuation of guideline-directed medical therapy. A trend towards poorer compliance was noted in the SPS group (22.5% vs. 7.5%; p = 0.060). An exploratory analysis revealed that patiromer initiation significantly increased tacrolimus levels in post-kidney transplant recipients (p = 0.003), necessitating dose adjustments. Conclusion: While both agents showed comparable potassium-lowering efficacy, patiromer\u2019s numerical advantages in tolerability and significant benefit in maintaining RAASi therapy position it as a valuable therapeutic option in this high-risk population.<\/jats:p>","DOI":"10.1159\/000553569","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T16:01:00Z","timestamp":1785945660000},"page":"842-853","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Patiromer and Sodium Polystyrene Sulfonate for Chronic Hyperkalemia in Patients with Chronic Kidney Disease: A Prospective Cohort Study"],"prefix":"10.1159","volume":"12","author":[{"given":"Mashael","family":"Alzahrani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douaa","family":"Sindi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9657-1155","authenticated-orcid":false,"given":"Saeed M. 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