Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials.

Détails

Ressource 1Télécharger: fmed-08-686729.pdf (1331.81 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_2E234990D128
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials.
Périodique
Frontiers in medicine
Auteur⸱e⸱s
Lizaraso-Soto F., Gutiérrez-Abejón E., Bustamante-Munguira J., Martín-García D., Chimeno M.M., Nava-Rebollo Á., Maurtua-Briseño-Meiggs Á., Fernández-Zoppino D., Bustamante-Munguira E., de Paz F.J., Grande-Villoria J., Ochoa-Sangrador C., Pascual M., Álvarez F.J., Herrera-Gómez F.
ISSN
2296-858X (Print)
ISSN-L
2296-858X
Statut éditorial
Publié
Date de publication
2021
Peer-reviewed
Oui
Volume
8
Pages
686729
Langue
anglais
Notes
Publication types: Systematic Review
Publication Status: epublish
Résumé
This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., β-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serum potassium level (sK+) 3.5-5.0 mEq/L) or acceptable kalemia (sK+ ≤ 5.1 mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8-25.2 g/day (SUCRA = 0.94) and patiromer 8.4-16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020185614, CRD42020185558, CRD42020191430.
Mots-clé
hyperkalemia, meta-analysis (as topic), mineralocorticoid receptor antagonists, nanomedicine, potassium-binding polymers
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/09/2021 16:57
Dernière modification de la notice
25/03/2023 7:09
Données d'usage