{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:27:20Z","timestamp":1787761640828,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Renin-angiotensin-aldosterone system inhibitors (RAASi) have been shown to improve outcomes in chronic kidney disease (CKD) patients but are associated with an increased risk of hyperkalemia in this vulnerable population. Hyperkalemia often leads to patients\u2019 downtitrating or discontinuing RAASi which can result in sub-optimal health outcomes. The objective is to evaluate the cost and health benefits of maintaining normokalemia using patiromer, an oral potassium binder while optimizing RAASi therapy in CKD patients in the Kingdom of Saudi Arabia. The medium-to long-term costs and health outcomes of patients with CKD stage 3\u20134 and raised serum potassium levels (\u22655.5 mmol\/L) at baseline were estimated, from a Saudi Arabia payer perspective, using a Markov state-transition model simulating the natural progression of CKD depending on patients\u2019 serum potassium level and usage of RAASi at different dosages. The analysis demonstrated that appropriate management of hyperkalemia, enabling optimization of RAASi, leads to cost and health benefits. The cost of patiromer is offset by 68% due to a reduction in management costs associated with CKD progression, hyperkalemia-related hospitalization, and cardiovascular (CV) events. Over a 10-year time horizon, a pool of 300 patients treated with patiromer experience increased life-expectancy [+3.78 life-years (LYs)] and slower disease progression, with decreased time spent in end-stage renal disease (\u20139.59 LYs). Patiromer may deliver value to both CKD patients and payers in Saudi Arabia, leading to better health outcomes for the former and reduced cost of management of CKD progression and CV events at low additional costs for the latter.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/1319-2442.374381","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T11:42:43Z","timestamp":1681904563000},"page":"S39-S52","source":"Crossref","is-referenced-by-count":0,"title":["Cost Consequence Analysis of the Management of Hyperkalemia by Patiromer and Optimization of Renin-Angiotensin-Aldosterone System Inhibitors Therapy in Chronic Kidney Disease Patients in Saudi Arabia"],"prefix":"10.4103","volume":"33","author":[{"given":"Faissal A. M.","family":"Shaheen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelie","family":"Meunier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz","family":"Altowaijri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talal","family":"Al Faadhel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Al-Abdulkarim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"AlGabash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lefteris","family":"Floros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20230924","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12882-016-0337-0","article-title":"Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: A systematic review and meta-analysis","volume":"17","author":"Currie","year":"2016","journal-title":"BMC Nephrol"},{"key":"R2-5-20230924","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1053\/j.ajkd.2015.10.011","article-title":"Reninangiotensin system inhibitors and kidney and cardiovascular outcomes in patients with CKD: A Bayesian network meta-analysis of randomized clinical trials","volume":"67","author":"Xie","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"R3-5-20230924","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1016\/j.resuscitation.2005.10.009","article-title":"European resuscitation council guidelines for resuscitation 2005. Section 4. 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arena","volume":"6","author":"Epstein","year":"2016","journal-title":"Kidney Int Suppl (2011"},{"key":"R7-5-20230924","first-page":"S212","article-title":"Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors","volume":"21","author":"Epstein","year":"2015","journal-title":"Am J Manag Care"},{"key":"R8-5-20230924","first-page":"S2","article-title":"Clinical and economic impact of hyperkalemia in patients with chronic kidney disease and heart failure","volume":"23","author":"Polson","year":"2017","journal-title":"J Manag Care Spec Pharm"},{"key":"R9-5-20230924","first-page":"s311","article-title":"Evaluation of clinical outcomes and costs based on prescribed dose level of renin-angiotensinaldosterone system inhibitors","volume":"22","author":"Epstein","year":"2016","journal-title":"Am J Manag 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hyperkalemia with patiromer among United States veterans","volume":"132","author":"Kovesdy","year":"2020","journal-title":"Postgrad Med"},{"key":"R28-5-20230924","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1093\/ckj\/sfz129","article-title":"Recurrent hyperkalaemia management and use of renin-angiotensin-aldosterone system inhibitors: A European multi-national targeted chart review","volume":"13","author":"Rossignol","year":"2020","journal-title":"Clin Kidney J"},{"key":"R29-5-20230924","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/ehf2.12402","article-title":"Serum potassium and clinical outcomes in heart failure patients: Results of risk calculations in 21 334 patients in the UK","volume":"6","author":"Linde","year":"2019","journal-title":"ESC Heart Fail"},{"key":"R32-5-20230924","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1159\/000481367","article-title":"UK renal registry 19th annual report: Chapter 5 survival and causes of death in UK 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haemodialysis in Jordan","volume":"13","author":"Batieha","year":"2007","journal-title":"East Mediterr Health J"},{"key":"R37-5-20230924","doi-asserted-by":"crossref","first-page":"e0165675","DOI":"10.1371\/journal.pone.0165675","article-title":"Health-related quality of life impacts mortality but not progression to end-stage renal disease in predialysis chronic kidney disease: A prospective observational study","volume":"11","author":"Jesky","year":"2016","journal-title":"PLoS One"},{"key":"R38-5-20230924","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1080\/13696998.2018.1454453","article-title":"Prospective utility study of patients with multiple cardiovascular events","volume":"21","author":"Pockett","year":"2018","journal-title":"J Med Econ"},{"key":"R39-5-20230924","first-page":"339","article-title":"End stage chronic kidney disease in Saudi Arabia. A rapidly changing scene","volume":"32","author":"Al-Sayyari","year":"2011","journal-title":"Saudi Med J"},{"key":"R40-5-20230924","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.3390\/jcm9082337","article-title":"New treatment options for hyperkalemia in patients with chronic kidney disease","volume":"9","author":"Esposito","year":"2020","journal-title":"J Clin Med"},{"key":"R41-5-20230924","doi-asserted-by":"crossref","first-page":"e281","DOI":"10.1097\/TP.0000000000002829","article-title":"Safety, Effectiveness, and tolerability of patiromer in kidney transplant recipients","volume":"103","author":"Lim","year":"2019","journal-title":"Transplantation"}],"container-title":["Saudi Journal of Kidney Diseases and Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.374381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:02:25Z","timestamp":1787760145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.374381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":31,"journal-issue":{"issue":"Suppl 1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/1319-2442.374381","relation":{},"ISSN":["1319-2442"],"issn-type":[{"value":"1319-2442","type":"print"}],"subject":[],"published":{"date-parts":[[2022,2]]}}}