Management of RAASi-associated hyperkalemia in patients with cardiovascular disease
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10451/46459 |
Resumo: | © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/ |
id |
RCAP_4e2dc742d88a847497bb8c952827ab86 |
---|---|
oai_identifier_str |
oai:repositorio.ul.pt:10451/46459 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Management of RAASi-associated hyperkalemia in patients with cardiovascular diseaseNovel potassium bindersHeart failure with reduced ejection fractionRenin–angiotensin–aldosterone system inhibitorsHyperkalemiaRAASi optimization© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/Renin-angiotensin-aldosterone system inhibitors (RAASi) reduce morbidity and mortality in heart failure (HF) with reduced ejection fraction in a dose-dependent manner. They also have a positive impact in other cardiovascular diseases (CVDs). However, RAASi may induce hyperkalemia, a potentially life-threatening disorder. This risk is further increased in those with concomitant chronic kidney disease, diabetes mellitus, and/or in patients with hypertension. Current treatment guidelines recommend maximal RAASi dosing to improve clinical outcomes; however, this is often limited by the development of hyperkalemia. When this occurs, current guidelines recommend RAASi down-titration/interruption, which, while improving short-term prognosis, is associated with a negative long-term prognostic impact. At present, the European Society of Cardiology suggests the consideration of novel potassium binders (patiromer and sodium zirconium cyclosilicate) for the management of RAASi-associated hyperkalemia. Both drugs can reduce serum potassium levels and prevent recurrent hyperkalemia. Additionally, patiromer showed enabling of RAASi optimization in high-risk patients. Nevertheless, precise recommendations on the use of these drugs are lacking. Building upon current HF guideline recommendations, a multidisciplinary expert panel convened to design an algorithm providing practical guidance on the use of novel potassium binders/patiromer in patients with HF and/or other CVD. As a result of that effort, we present an evidence-based treatment algorithm for the management of hyperkalemia with novel potassium binders/patiromer in patients with HF and/or other CVD receiving RAASi, including the necessary monitoring to avoid induction of hypokalemia. This algorithm aims to maintain or up-titrate RAASi to optimized doses, while maintaining normokalemia, improved clinical outcomes, and long-term prognosis.This work was supported by Vifor Pharma, Portugal, via an educational grant.Springer NatureRepositório da Universidade de LisboaSilva-Cardoso, JoséBrito, DulceFrazão, João MiguelFerreira, AníbalBettencourt, PauloBranco, PatríciaFonseca, Cândida2021-02-22T16:52:52Z20212021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/46459engHeart Fail Rev. 2021 Feb 181382-414710.1007/s10741-020-10069-31573-7322info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T16:48:47Zoai:repositorio.ul.pt:10451/46459Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:58:38.497748Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
title |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
spellingShingle |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease Silva-Cardoso, José Novel potassium binders Heart failure with reduced ejection fraction Renin–angiotensin–aldosterone system inhibitors Hyperkalemia RAASi optimization |
title_short |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
title_full |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
title_fullStr |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
title_full_unstemmed |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
title_sort |
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease |
author |
Silva-Cardoso, José |
author_facet |
Silva-Cardoso, José Brito, Dulce Frazão, João Miguel Ferreira, Aníbal Bettencourt, Paulo Branco, Patrícia Fonseca, Cândida |
author_role |
author |
author2 |
Brito, Dulce Frazão, João Miguel Ferreira, Aníbal Bettencourt, Paulo Branco, Patrícia Fonseca, Cândida |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
dc.contributor.author.fl_str_mv |
Silva-Cardoso, José Brito, Dulce Frazão, João Miguel Ferreira, Aníbal Bettencourt, Paulo Branco, Patrícia Fonseca, Cândida |
dc.subject.por.fl_str_mv |
Novel potassium binders Heart failure with reduced ejection fraction Renin–angiotensin–aldosterone system inhibitors Hyperkalemia RAASi optimization |
topic |
Novel potassium binders Heart failure with reduced ejection fraction Renin–angiotensin–aldosterone system inhibitors Hyperkalemia RAASi optimization |
description |
© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/ |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-02-22T16:52:52Z 2021 2021-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10451/46459 |
url |
http://hdl.handle.net/10451/46459 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Heart Fail Rev. 2021 Feb 18 1382-4147 10.1007/s10741-020-10069-3 1573-7322 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Springer Nature |
publisher.none.fl_str_mv |
Springer Nature |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799134532485513216 |