Increasing potassium intake ameliorates blood pressure (BP) and cardiovascular (CV) prognoses in the general population; therefore the World Health Organization recommends a high-potassium diet (90–120 mEq/day). Hyperkalaemia is a rare condition in healthy individuals due to the ability of the kidneys to effectively excrete dietary potassium load in urine, while an increase in serum K+ is prevalent in patients with chronic kidney disease (CKD). Hyperkalaemia prevalence increases in more advanced CKD stages, and is associated with a poor prognosis. This scenario generates controversy on the correct nutritional approach to hyperkalaemia in CKD patients, con-sidering the unproven link between potassium intake and serum K+ levels. Another concern is that drug-induced hyperkalaemia leads to the down-titration or withdrawal of renin-angiotensin system inhibitors (RASI) and mineralocorticoids receptors antagonists (MRA) in patients with CKD, de-priving these patients of central therapeutic interventions aimed at delaying CKD progression and decreasing CV mortality. The new K+-binder drugs (Patiromer and Sodium-Zirconium Cyclosili-cate) have proven to be adequate and safe therapeutic options to control serum K+ in CKD patients, enabling RASI and MRA therapy, and possibly, a more liberal intake of fruit and vegetables.

Borrelli S., Matarazzo I., Lembo E., Peccarino L., Annoiato C., Scognamiglio M.R., et al. (2022). Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 23(12), 1-13 [10.3390/ijms23126378].

Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers

Borrelli S.;Provenzano M.;La Manna G.;Garofalo C.
2022

Abstract

Increasing potassium intake ameliorates blood pressure (BP) and cardiovascular (CV) prognoses in the general population; therefore the World Health Organization recommends a high-potassium diet (90–120 mEq/day). Hyperkalaemia is a rare condition in healthy individuals due to the ability of the kidneys to effectively excrete dietary potassium load in urine, while an increase in serum K+ is prevalent in patients with chronic kidney disease (CKD). Hyperkalaemia prevalence increases in more advanced CKD stages, and is associated with a poor prognosis. This scenario generates controversy on the correct nutritional approach to hyperkalaemia in CKD patients, con-sidering the unproven link between potassium intake and serum K+ levels. Another concern is that drug-induced hyperkalaemia leads to the down-titration or withdrawal of renin-angiotensin system inhibitors (RASI) and mineralocorticoids receptors antagonists (MRA) in patients with CKD, de-priving these patients of central therapeutic interventions aimed at delaying CKD progression and decreasing CV mortality. The new K+-binder drugs (Patiromer and Sodium-Zirconium Cyclosili-cate) have proven to be adequate and safe therapeutic options to control serum K+ in CKD patients, enabling RASI and MRA therapy, and possibly, a more liberal intake of fruit and vegetables.
2022
Borrelli S., Matarazzo I., Lembo E., Peccarino L., Annoiato C., Scognamiglio M.R., et al. (2022). Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 23(12), 1-13 [10.3390/ijms23126378].
Borrelli S.; Matarazzo I.; Lembo E.; Peccarino L.; Annoiato C.; Scognamiglio M.R.; Foderini A.; Ruotolo C.; Franculli A.; Capozzi F.; Yavorskiy P.; Me...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/960159
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