{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:30:15Z","timestamp":1786480215899,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2022,12]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Hyperkalemia is frequently observed in patients with CKD, and its frequency and severity increase as CKD progresses.<\/jats:p>\n <\/jats:list-item>\n \n Patiromer is an effective and well-tolerated treatment option for hyperkalemia in patients with advanced or mild\/ moderate CKD on RAASi.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n \n Hyperkalemia is a common electrolyte abnormality in patients with CKD, which is associated with worse outcomes and limits use of renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi). This\n post hoc<\/jats:italic>\n subgroup analysis of three clinical trials evaluated the efficacy and safety of the sodium-free, potassium-binding polymer, patiromer, for the treatment of hyperkalemia in adults with nondialysis CKD.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Data from the 4-week treatment periods of AMETHYST-DN, OPAL-HK, and TOURMALINE studies were combined. Patients had baseline diagnosis of CKD, hyperkalemia (serum potassium >5.0 mEq\/L), and received patiromer 8.4\u201333.6 g\/day. Patients were stratified by baseline eGFR into two subgroups: severe\/end-stage CKD (stage 3b\u20135; eGFR <45 ml\/min per 1.73 m\n 2<\/jats:sup>\n ) and mild\/moderate CKD (stage 1\u20133a; eGFR \u226545 ml\/min per 1.73 m\n 2<\/jats:sup>\n ). Efficacy was assessed by the change in serum potassium (mean\u00b1SE) from baseline to week 4. Safety assessments included incidence and severity of adverse events (AEs).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Efficacy analyses (\n n<\/jats:italic>\n =626; 62% male, mean age 66 years) included 417 (67%) patients with severe\/end-stage CKD and 209 (33%) with mild\/moderate CKD. Most patients were receiving RAASi therapy at baseline (severe\/end-stage CKD 92%; mild\/moderate CKD 98%). The mean\u00b1SE change in serum potassium (baseline to week 4) was \u22120.84\u00b10.03 in the severe\/end-stage CKD subgroup, and \u22120.60\u00b10.04 mEq\/L in the mild\/moderate CKD subgroup. AEs were reported for 40% and 27% patients in the severe\/end-stage and mild\/moderate CKD subgroups, respectively, with 16% and 12% reporting AEs considered related to patiromer. The most frequent AEs were mild-to-moderate constipation (8% and 3%) and diarrhea (4% and 2%). AEs leading to patiromer discontinuation occurred in 6% and 2% of patients with severe\/end-stage CKD, and mild\/moderate CKD, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patiromer was effective for treatment of hyperkalemia and well tolerated in patients across stages of CKD, most of whom were receiving guideline-recommended RAASi therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0001562022","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T17:40:19Z","timestamp":1659462019000},"page":"2019-2026","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Safety and Efficacy of Patiromer in Hyperkalemic Patients with CKD: A Pooled Analysis of Three Randomized Trials"],"prefix":"10.34067","volume":"3","clinical-trial-number":[{"clinical-trial-number":"nct01371747","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01810939","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02694744","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8361-6446","authenticated-orcid":false,"given":"Hermann","family":"Haller","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Hanover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3981-6325","authenticated-orcid":false,"given":"Stefano","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Nephrology and Dialysis Complex Operative Unit, Livorno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0762-2270","authenticated-orcid":false,"given":"Kieran","family":"McCafferty","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Arthur","sequence":"additional","affiliation":[{"name":"Biostatistics, Vifor Pharma Group, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-3991","authenticated-orcid":false,"given":"Carol Moreno","family":"Quinn","sequence":"additional","affiliation":[{"name":"Medical Affairs, Vifor Pharma Group, Glattbrugg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery","family":"Budden","sequence":"additional","affiliation":[{"name":"Medical Affairs, Vifor Pharma Group, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8820-5702","authenticated-orcid":false,"given":"Matthew R.","family":"Weir","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"B1-20250825","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1093\/eurheartj\/ehy100","article-title":"Serum potassium and adverse outcomes across the range of kidney function: A CKD Prognosis Consortium meta-analysis","volume":"39","author":"Kovesdy","year":"2018","journal-title":"Eur Heart J"},{"issue":"Suppl 3","key":"B2-20250825","doi-asserted-by":"crossref","first-page":"iii2","DOI":"10.1093\/ndt\/gfz206","article-title":"Hyperkalemia: Pathophysiology, risk factors and 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