New Agents for Hyperkalemia

New England Journal of Medicine 372(16):1569 (2015) PMID 25875263

To the Editor: In the study by Weir et al. (Jan. 15 issue),1 the low baseline rate of use of loop diuretics (32% of patients) is noteworthy and might limit the clinical applicability of their finding that patiromer was effective in reducing hyperkalemia in patients with chronic kidney disease receiving renin–angiotensin–aldosterone system (RAAS) inhibitors. The African American Study of Kidney Disease and Hypertension (AASK) enrolled 1094 black patients with chronic kidney disease that was attributed to hypertension. In AASK, approximately 40% of the participants were randomly assigned to RAAS blockade. During 3.0 to 6.4 years of follow-up, only 80 hyperkalemic . . .

DOI: 10.1056/NEJMc1501933