Sodium Zirconium Cyclosilicate in Hyperkalemia

Sodium zirconium cyclosilicate was associated with larger reduction in serum K+ at 48 hours than placebo (0.5-0.7 vs. 0.3 mmol/L), and the 5g and 10g doses were associated with serum levels of 4.7 and 4.5 mmol/L during maintenance days 3-15 (vs. >5.0mmol/L with placebo).

Sodium zirconium cyclosilicate is a potassium binding modulator currently in Phase III development for the treatment of hyperkalaemia.

This study included patients with a variety of diagnoses associated with hyperkalaemia. The majority (75%) had reduced renal function, 60% had diabetes and 40% had heart failure; in addition, 65% were receiving RAAS inhibitors. As noted in an accompanying editorial, there were few adverse events reported; the study was however short and the durability and side-effect profile over time remains unclear. Further study is required to determine whether the co-administration of patiromer would permit long-term administration of RAAS blockers in this setting.