title: Role of Hyperkalemia in Heart Failure and the Therapeutic Use of Potassium Binders.
abstract: Hyperkalemia can be a life-threatening disorder, especially for at-risk patients with heart failure, chronic kidney disease, with diabetes, and patients on certain drugs like renin-angiotensin-aldosterone system antagonists and mineralocorticoid receptor antagonists. There are limited therapeutic options available for hyperkalemia, and they have narrow effectiveness because of their unfavorable side effects profile in long-term and high cost utilization requiring inpatient care. Patiromersorbitex calcium and sodium zirconium cyclosilicate are novel potassium-lowering compounds for the treatment and prevention of hyperkalemia in at-risk population. These therapeutic agents have shown encouraging results in early phase II and phase III clinical trials. However, there is need to further study their efficacy and safety in heart failure population in order to establish their clinical use. The focus of this chapter will be to promote better understanding of potassium homeostasis in heart failure patients and the mechanistic overview of novel drugs, with emphasis on heart failure population.
authors.affiliation: Cardiology Division, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Chaudhry M S
authors.initials: CMS
authors.lastname: Sarwar
authors.affiliation: Cardiology Division, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Aditi A
authors.initials: AA
authors.lastname: Bhagat
authors.affiliation: Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Cardiology Division, Stony Brook University, Stony Brook, NY, USA. javed.butler@stonybrookmedicine.edu.
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D001794:Blood Pressure; D002614:Chelating Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects; D011108:Polymers / Q000627:therapeutic use; D011137:Polystyrenes / Q000627:therapeutic use; D012084:Renin-Angiotensin System; D017640:Silicates / Q000627:therapeutic use
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002614:Chelating Agents; D000451:Mineralocorticoid Receptor Antagonists; D011108:Polymers; D011137:Polystyrenes; D017640:Silicates; C568789:patiromer; C003321:polystyrene sulfonic acid; C000597310:sodium zirconium cyclosilicate
keywords: Angiotensin converting enzyme inhibitors; Angiotensin receptor blockers; Chronic kidney disease; Heart failure; Hyperkalemia; Mineralocorticoid receptor antagonist; Patiromer; Renin-angiotensin-aldosterone system inhibitors and sodium polystyrene sulfonate; Sodium zirconium cyclosilicate