Enhancing the knowledge of primary care physicians and internists with respect to the safety profiles of these newer K+ binders may increase confidence in managing patients with hyperkalemia. Across the Veltassa ® clinical trial program, over 99 percent of participants were also taking RAASi therapy. Patiromer and maintenance of RAASi therapy in hyperkalemic Medicare patients. Circulation. Epstein M et al. After watching the videos on RAASi and hyperkalemia in cardiorenal disease, the learner should be able to: Explain the challenge of following guideline recommended (dose of) RAASi therapy in cardiorenal patients; Recall the association between serum potassium levels and outcomes; Describe determinants and prevalence of hyperkalemia in HF 5. Among these cohorts, we evaluated RAASi continuation and dose reductions within 1-, 3- and 6-month time frames. Eur Heart J. Combined with RASi therapeutics, which inhibit potassium excretion by the kidneys, older patients with diabetic kidney disease are 50% more likely to develop hyperkalemia than the general population and should have their serum potassium levels closed monitored every two to four weeks. RAASi therapy benefit and challenges in cardio-renal patients Session: Enabling and optimising RAASi therapy for cardio-renal patients by controlling potassium levels Lisbon 2017 Dürrenmatt Hall 14. 2018;doi:10.1080/03007995.2018.1433141. 1. Disclosure: Desai reports he is a consultant for Relypsa Pharmaceuticals. RAASi therapy can increase the risk of hyperkalemia, and physicians may decide to reduce the dose or discontinue RAASi therapy following hyperkalemia. Desai A. Robert D. Toto (2019) Patiromer and maintenance of RAASi therapy in hyperkalemic medicare patients, Journal of Drug Assessment, 8:sup1, 2-2, DOI: 10.1080/21556660.2019.1658287 He is the Editor or Co-Editor of 21 books as well as the new 3rd edition of Hypertension: A Companion to Braunwald’s The Heart. Betts KA, et al. 3. Doing so will enable their older patients to continue to reap the cardiorenal protective benefits of RASi therapies, and will improve overall patient outcomes. Physicians commonly use a renin-angiotensin-aldosterone system inhibitor (RAASi) to reduce the risk of death and to slow disease progression in patients with heart failure. 2015;doi:10.1056/NEJMoa1410853. Due to this, it becomes imperative that these patients are diagnosed and provided aggressive intervention as early as possible to prevent or delay the progression of the disease and associated comorbidities, such as hypertension. Down-regulation of RAASi therapy is a common strategy in the chronic management of hyperkalaemia but studies show that sub-maximum doses or discontinuation is associated with poor outcomes. Current Medical Research and Opinion. With the elderly population in the United States estimated to double to 71 million by 2030, clinicians will begin caring for sicker patients living with age-related illnesses and multiple comorbidities, including diabetic kidney disease. Recent clinical studies suggest that the newer K+ binders (patiromer sorbitex calcium and sodium zirconium cyclosilicate) may facilitate optimization of RAASi therapy. We identified three cohorts of hyperkalemia diagnoses: those treated with patiromer; those treated with SPS; and those not treated with any potassium binder. Often overlooked and recurrent, hyperkalemia impacts approximately three million Americans — with most of them reporting no symptoms. These drugs bind with potassium, decreasing the amount available for absorption in the gastrointestinal tract, thereby enabling the use and continuation of RASi therapy in patients living with kidney disease. Pitt B, et al. McCullough PA. Nephron 2018;doi:10.1159/000485645. In particular, data from the ESC HF registry reveal that RAASi were frequently underdosed because of persistent and consistent hyperkalemia and/or worsening renal function. *1. Due to this significantly elevated risk, older patients with diabetic kidney disease can become challenging to treat for clinicians. This original research developed a model to quantify the health and economic benefits of maintaining normokalaemia and enabling optimal RAASi therapy in patients with CKD. More recently, a post-hoc subgroup analysis of the AMETHYST-DN study in diabetic kidney disease patients aged 75 years or older was reported at the American Diabetes Association 79th Scientific Sessions. Film career. 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