Patiromer for Treatment of Hyperkalemia in the Emergency Department: A Pilot Study

• DOI: 10.1111/acem.13868
• Publication Date: 2019-10-10T07:53:30Z
• Authors: Zubaid Rafique; Mengyang Liu; Kristen A. Staggers; Charles G. Minard; W. Frank Peacock
• Keywords: Clearance

Abstract Background Hyperkalemia is common and potentially life threatening. Patiromer a Food Drug Administration (FDA)‐cleared oral potassium binder effective in the chronic treatment of hyperkalemia. Objective The objective was to investigate potential efficacy safety patiromer treating acute hyperkalemia emergency department (ED). Methods This single‐center, randomized, open‐label convenience sample pilot study an inner‐city ED. Adult patients with end‐stage renal disease serum level ≥ 6.0 mEq/L were randomized standard care (SOC) or one dose 25.2 g plus SOC (PAT). Blood samples electrocardiograms collected at enrollment 1, 2, 4, 6 hours thereafter. primary outcome difference between groups hours. Secondary outcomes amount number times insulin albuterol given. Results Thirty included final analysis, 15 each group. There no differences age, sex, baseline potassium. mean PAT (6.32 mEq/L, confidence interval [CI] = 6.63 vs. 5.81 CI 5.48 6.14 mEq/L). However, 2 posttreatment group lower than (5.90 5.63 6.17 6.51 6.25 6.78 mEq/L) also 0.61 baseline. administrations groups, although used but not significant (median, 0 mg 12.5 mg; p 0.097). adverse events groups. Conclusion In this severe hyperkalemia, single reduced within did show first showing that may have role management hyperkalemia; however, more rigorous studies are needed.