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Hyperkalemia in Patients on Peritoneal Dialysis: Clinical Use Experience with New Potassium-Binders

Open Journal of Nephrology 2024年第3期14卷 324-333页

作者： gennaro argentino Mario Iorio Alessandra Antonia Mele Andrea Camocardi Enrica Emanuela Cascone Maria Elena Liberti Adelia Sagliocca Andrea Pota Luigi Russo Maria Luisa Sirico Germano Terzini Michele Cavasso Chiara Mennillo Francesca Nettuno Raffaele Genualdo Giuseppe Surfaro Lucia Di Micco UOC Nefrologia e Dialisi Ospedale del Mare Naples Italy UOC Chirurgia Generale Ospedale del Mare Naples Italy

Background: Patients with end-stage kidney disease (ESKD) on maintenance dialysis have a high risk of developing hyperkalemia. In addition to traditional approaches, a new option for the management of patients on dialysis includes the use of a potassium binder, sodium zirconium cyclosilicate (SZC). We evaluated the effect and safety of SZC in patients with chronic PD. Objective: To present a case series that illustrates the real-world use of new potassium-binders in hyperkalemic patients on peritoneal dialysis. Methods: This case series collected 9 patients on PD with baseline potassium values > 5.5 mmol/l and who were treated with SZC 5 g once a day. Data were collected at baseline and at 1, 2, and 3 months after initiation of treatment. Results: The median age of patients was 64.5 years and the median duration of observation was 90 ± 5 days. It was observed that median serum potassium decreased (5.8 mmol/l at baseline with a range of 5.8 mmol/L - 6.8 mmol/L versus 4.5 in the third month with a range of 3.6 mmol/L - 5.3 mmol/L) after SZC treatment. Adverse events were observed in 2 (22.2%). The unique adverse event was constipation and presented in 2 patients (22.2%). Constipation was mild and transient during the observation period. No adverse events of special interest were reported. Conclusion: Normokalemia was established and maintained in this series of patients treated with SZC. No episodes of hyper- or hypo-kalemia were observed. SCZ had a good safety profile and was well tolerated over 3 months.

关键词： SZC Sodium Zirconium Cyclosilicate Hyperkalaemia Peritoneal Dialysis

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Successful Treatment of Peritoneal Dialysis Related Peritonitis from Multi-Drug Resistant Sphingomonas paucimobilis with Combination Therapy: A Case Report

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Open Journal of Nephrology 2022年第2期12卷 228-234页

作者： gennaro argentino Silvio Borrelli Ciro Paglionico Andrea Camocardi Mario Iorio Alessandra Antonia Mele Andrea Pota Adelia Sagliocca Stefania Brancaccio Lucia Di Micco “Ospedale del Mare” Nephrology and Dialysis Unit ASL Napoli 1 Centro Naples Italy Nephrology and Dialysis Unit University of Studies of Campania “Luigi Vanvitelli” Naples Italy

Sphingomonas paucimobilis is an emerging gram-negative aerobic bacterium, generally causing infections in immunocompromised patients. Few data are available about peritonitis in peritoneal dialysis due to this pathogen. The clinical courses and outcomes of peritonitis are variable, with a high frequency of catheter removal and peritoneal dialysis withdrawal. No guidelines are available for the treatment of Sphingomonas paucimobilis related peritonitis, due to its emerging role as pathogen, the high antibiotic resistance and unpredictable antibiotic sensitivity. Here, we describe a case of Sphingomonas paucimobilis peritonitis in a 52-year-old diabetic patient in Continuous Cycler-Assisted Peritoneal Dialysis (CCPD) for 4 months, successfully treated with a combined intraperitoneally administration of meropenem (250 mg/L) and ciprofloxacin (100 mg/L) for 21 days. No hospital admission and change of peritoneal dialysis scheme were needed;no relapses of peritonitis were observed during 18 months of follow-up.

关键词： Sphingomonas paucimobilis Peritoneal Dialysis Peritonitis Antibiotic Therapy

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