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Egyptian Consensus on Hyperkalemia Management: Lessons from Recent Evidences

International Journal of Clinical Medicine 2023年第9期14卷 402-418页

作者： Magdy Abdelhamid Tarek El Baz Mohamed H. Hafez May A. Hassaballa Hesham Elsayed Magdi El Sharkawy Ahmed F. ElKeraie Gamal Saadi Emad R. Issak Department of Cardiovascular Medicine Faculty of Medicine Kasr Al-Aini Cairo University Cairo Egypt Department of Nephrology Faculty of Medicine Al-Azhar University Cairo Egypt Department of Nephrology Faculty of Medicine Kasr Al-Aini Cairo University Cairo Egypt Department of Nephrology Faculty of Medicine Ain Shams University Cairo Egypt Department of Nephrology Faculty of Medicine Alexandria University Alexandria Egypt Department of Internal Medicine Faculty of Medicine Ain Shams University Cairo Egypt

Acute and chronic hyperkalemia is linked to higher hospitalization rates and mortality rates. It has a high prevalence among dialysis and non-dialysis patients in Egypt. The current therapy options are not that ideal. Moreover, we have a critical management paradox in cardiorenal diseases: Should we use the optimum dose of RAASi with its higher incidence of HK, or should we decrease the dose or even stop it with all its harmful hazards? Therefore, in light of the recent updates in different clinical practice guidelines, we, a country-specific (Egypt) task force, gathered to develop a clear, evidence-based, and multi-disciplinary consensus for managing HK. This manuscript illustrates the recommendations of this expert committee. The panel recommends new evidenced K binders like Sodium Zirconium Cyclosilicate (SZC) and patiromer to help manage HK in cardiorenal patients as stated by different international guidelines. In emergency settings, SZC can have a role in managing acute HK;however, it should be used in addition to other drugs like insulin and glucose. Local research studies on the utilization of these novel K binders are highly recommended. The utilization of these novel K binders as prophylaxis should be tested first in a well-designed randomized controlled trial.

关键词： Hyperkalemia potassium binders Sodium Zirconium Cyclosilicate Patiromer

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