Potassium Binding for Conservative and Preservative Management of Chronic Kidney Disease

Deborah J. Clegg; Biff F. Palmer


Curr Opin Nephrol Hypertens. 2020;29(1):29-38. 

In This Article


There are now two new drugs approved for clinical use for management of hyperkalemia in addition to SPS. These drugs are novel, orally administered, with better tolerability, and provide a more predictive K+-lowering dose–response compared with SPS. These drugs can potentially enable continued use of RAASi therapy at adequate doses while maintaining normokalemia in CKD patients. Given that both patiromer and SZC are well tolerated, safe, and effective, healthcare providers now have two viable choices to consider for long-term management of hyperkalemia. The introduction of safe, effective, and well tolerated K+ binders is not simply a measure to treat hyperkalemia, but it may facilitate more opportunity to optimize RAASi therapy and dietary liberalization in patients with CKD and/or cardiovascular disease.