Patiromer utilization in patients with advanced chronic kidney disease under nephrology care in Germany.

Autor: Pecoits-Filho R; Arbor Research Collaborative for Health, Ann Arbor, MI, USA.; Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil., McCullough K; Arbor Research Collaborative for Health, Ann Arbor, MI, USA., Muenz D; Arbor Research Collaborative for Health, Ann Arbor, MI, USA., Quinn CM; Vifor Pharma, Glattburg, Switzerland., Budden J; Vifor Pharma, Redwood City, USA., Golden J; Vifor Pharma Germany, Munich., de Arellano AR; Vifor Pharma, Glattburg, Switzerland., Tillmann FP; Department of Medicine I - Nephrology, Transplantation & Medical Intensive Care, University Witten/Herdecke, Medical Center Cologne-Merheim, Cologne, Germany., Duttlinger J; Deutsche Nierenzentren eV, WiNe Institute, Düsseldorf, Germany., Calice-Silva V; Pro-Rim Foundation, Joinville, SC, Brazil.; UNIVILLE, Joinville, SC, Brazil., Massy ZA; Department of Nephrology, CHU Ambroise Paré, APHP, Boulogne, France.; Center for Research in Epidemiology and Population Health (CESP), University Paris Saclay, University Versailles Saint-Quentin en Yvelines, National Institute of Health, Clinical Epidemiology Team, Villejuif, France.; Division of Nephrology, Ambroise Paré Universitry Hospital, APHP, Paris, France., Bieber B; Arbor Research Collaborative for Health, Ann Arbor, MI, USA., Robinson BM; Arbor Research Collaborative for Health, Ann Arbor, MI, USA., Fliser D; Saarland University Medical Centre, Homburg, Germany., Reichel H; Nephrological Center, Villingen-Schwenningen, Baden-Württemberg, Germany.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2022 Oct 11; Vol. 16 (1), pp. 176-183. Date of Electronic Publication: 2022 Oct 11 (Print Publication: 2023).
DOI: 10.1093/ckj/sfac209
Abstrakt: Background: Hyperkalemia (HK) is a frequent condition in patients with chronic kidney disease (CKD) that is associated with high morbidity and mortality. Patiromer has recently been introduced as a potassium binder. Data on patiromer use in patients with CKD in the real-world setting in Europe are lacking. We describe time to discontinuation and changes in serum potassium levels among German CKD stage 3-5 patients starting patiromer.
Methods: Duration of patiromer use was estimated by Kaplan-Meier curve, starting at patiromer initiation and censoring for death, dialysis, transplant or loss to follow-up. Serum potassium levels and renin-angiotensin-aldosterone system inhibitor (RAASi) use are described at baseline and during follow-up, restricted to patients remaining on patiromer.
Results: We identified 140 patiromer users within our analysis sample [81% CKD stage 4/5, 83% receiving RAASi, and median K+ 5.7 (5.4, 6.3) mmol/L]. Thirty percent of patiromer users had prior history of polystyrene sulfonate use. Overall, 95% of patiromer users stayed on treatment past 1 month, with 53% continuing for over a year. Mean serum potassium levels decreased after patiromer initiation and remained stable under treatment during follow-up (up to 180 days). Among these patients, 73%-82% used RAASis during the time periods before and after patiromer initiation, with no obvious trend indicating discontinuation.
Conclusion: Real-world evidence of patiromer use in Germany shows that, in line with what has been observed in clinical trials, patients on patiromer have a reduction in serum potassium when used long-term. Moreover, most patients on patiromer do not discontinue treatment prior to 1 year after initiation.
(© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)
Databáze: MEDLINE
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