Challenges and Considerations in the Management of Hyperkalaemia in Patients With Chronic Kidney Disease

This CME symposium took place on 23rd May 2016 as a part of the European Renal Association – European Dialysis and Transplantation Association (ERA-EDTA) Congress 2016 in Vienna, Austria

Chairperson: David Goldsmith1
Speakers: Johannes F. E. Mann,2,3 Martin H. de Borst3

1. Renal Unit, Guy’s and St Thomas’ Hospital, London, UK
2. Department of Nephrology and Hypertension, Friedrich Alexander University Erlangen-Nürnberg and KfH Kidney Center, Munich-Schwabing, Germany
3. Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

Disclosure: Prof Goldsmith has received funding from Abbvie, Astellas, Bayer, Fresenius Medical Care, Keryx, Relyps, Roche, Sandoz, Sanofi, Shire, Vifor, and ZS Pharma. Prof Mann received honoraria for serving as a speaker from Amgen, Astra, Braun, Fresenius, Gambro, Medice, Novo Nordisk, Relypsa, and Roche; received research funding from the European Union, Canadian Institutes Health Research, Boehringer, Celgene, Novo Nordisk, Roche, and Sandoz; and acted as a consultant for Abbvie, Astra, Celgene Fresenius, Lilly, Lanthio, Novo Nordisk, Relypsa, Sanifit, and Vifor. Dr de Borst acted as a consultant for Amgen.
Acknowledgements: Writing assistance was provided by Maxwell Chang of ApotheCom.
Support: The publication of this article was funded by AstraZeneca. The views and opinions expressed are those of the authors and not necessarily AstraZeneca.
Citation: EMJ. 2016;1[3]:44-50.

Meeting Summary

Prof David Goldsmith opened the symposium by highlighting the objectives of the meeting. The education objectives of the symposium were to summarise the mechanisms that regulate potassium balance, specifically highlighting how these mechanisms are affected by inhibition of the renin-angiotensinaldosterone system (RAAS); to examine the pathophysiology of hyperkalaemia and illustrate the impact on clinical outcomes; to evaluate current clinical evidence and outline key considerations that help determine the urgency; and to describe recent clinical trial data on investigational oral ion exchangers and the potential future role of these emerging therapies in clinical practice.
In the first presentation, Prof Johannes F. E. Mann discussed the predisposing factors of hyperkalaemia by presenting a case of a heart failure (HF) patient with Stage 3 chronic kidney disease (CKD), and also discussed the epidemiology and pathophysiology of hyperkalaemia. Dr Martin H. de Borst then discussed the current therapeutic options available for the outpatient treatment of hyperkalaemia, along with recent clinical data on novel treatments, in particular patiromer and zirconium cyclosilicate (known as ZS-9).

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