title: Gastrointestinal potassium binding-more than just lowering serum [K(+)]: patiromer, potassium balance, and the renin angiotensin aldosterone axis.
abstract: Hyperkalemia limits the use of renin-angiotensin-aldosterone axis (RAAS) blockers in patients with renal insufficiency. This can be managed by efforts to increase kaliuresis and by gastrointestinal potassium binding with sodium polystyrene sulfonate, a relatively ineffective agent. Now with the availability of patiromer, RAAS blockers can be used more liberally. In addition, potassium reduction decreases aldosterone, which may be beneficial. Adverse nonepithelial aldosterone effects such as endothelial dysfunction and cardiac fibrosis may be ameliorated.
authors: Department of Medicine, Baylor University Medical Center, Dallas, Texas, USA; Texas A & M Health Science Center, College of Medicine, Texas A&M University, Bryan, Texas, USA.
authors: Michael
authors: M
authors: Emmett
authors: Department of Medicine, Baylor University Medical Center, Dallas, Texas, USA; Texas A & M Health Science Center, College of Medicine, Texas A&M University, Bryan, Texas, USA. Electronic address: ankitm@baylorheath.edu.
authors: Ankit
authors: A
authors: Mehta
mesh_terms: D000450:Aldosterone; D000809:Angiotensins; D006801:Humans; D006947:Hyperkalemia / Q000097:blood; D011108:Polymers; D011188:Potassium / Q000097:blood*; D012083:Renin; D012084:Renin-Angiotensin System
chemical_list: D000809:Angiotensins; D011108:Polymers; C568789:patiromer; D000450:Aldosterone; D012083:Renin; D011188:Potassium