Management of RAASi-associated hyperkalemia in patients with cardiovascular disease

Detalhes bibliográficos
Autor(a) principal: Silva-Cardoso, José
Data de Publicação: 2021
Outros Autores: Brito, Dulce, Frazão, João Miguel, Ferreira, Aníbal, Bettencourt, Paulo, Branco, Patrícia, Fonseca, Cândida
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/
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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
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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
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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
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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
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