Short-term efficacy and safety of different doses of sodium zirconium cyclosilicate on potassium reduction in patients with hyperkalemia in the perioperative period of kidney transplantation
Objective To investigate the efficacy and safety of different doses of sodium zirconium cyclosilicate(SZC)in the rapid correction of hyperkalemia in patients with different blood potassium levels in the perioperative period of kidney transplantation.Methods A prospective study waw performed to select patients admitted to Nanfang Hospital from June 2023 to January 2024.Inclusion criteria:① Patients with chronic kidney disease stage 5;(2)Patients aged 18 to 65 years old;③Serum potassium is between 5.0 mmol/L and 7.0 mmol/L.Exclusion criteria:①Combined with other potassium reduction measures;②Pregnant woman or suckling period woman;③Patients judged by the investigator as unsuitable for participation in this trial.Qualified patients were randomly given different doses(5g,10g,15g)of SZC by means of random number table.Venous potassium was measured at 0.5h,1h,2h,3h and 4h after medication and adverse effects were observed.In addition,patients were retrospectively divided into mild hyperkalemia group(serum potassium 5.0-5.5 mmol/L)and moderate/severe hyperkalemia group(serum potassium ≥ 5.5 mmol/L)according to the baseline serum potassium.The extent of decrease of blood potassium and the number of people who recovered to normal within 4 hours after medication in different dose groups,and the correlation between dosage,baseline potassium and recovery of blood potassium 4h after dosing were evaluated.Additionally,safety was evaluated by observing whether the patient had edema,gastrointestinal symptoms,etc.Results A total of 34 patients were enrolled,including 10 in 5g group,13 in 10g group,and 11 in 15g group.Among the three groups,age were[(41.90±11.51)years old vs.(44.15±10.51)years old vs.(42.91±10.78)years old],gender(male/female:9/1 cases vs.9/4 cases vs.8/3 cases),body mass index[(23.08±3.54)kg/m2 vs.(23.03±2.92)kg/m2 vs.(23.47±2.99)kg/m2],estimated glomerular filtration rate[(4.80±2.13)ml/(min·1.73m2)vs.(5.26±1.14)ml/(min·1.73m2)vs.(4.85± 1.48)ml/(min·1.73m2)],baseline blood potassium[(5.65±0.43)mmol/L vs.(5.59±0.25)mmol/L vs.(5.94±0.64)mmol/L].There was no statistically significant difference among the three groups(P＞0.05).The blood potassium levels decreased to(5.20±0.65)mmol/L vs.(5.03±0.35)mmol/L vs.(5.10±0.46)mmol/L in the three groups 4h after dosing,respectively,with statistically significant difference compared with baseline(P＜0.05).In three(30.0％),five(38.5％)and five(45.5％)cases in the three groups respectively,serum potassium returned to normal(3.5-5.0 mmol/L)4 hours after medication,with no statistically significant difference(x2=0.530,P=0.904).Mild hyperkalemia group includes 12 cases while moderate/severe hyperkalemia group includes 22 cases.For the two groups,age were[(43.83±9.38)years old vs.(42.73±11.30)years old],gender(male/female:11/1 cases vs.15/7 cases),body mass index[(24.27±2.69)kg/m2 vs.(22.35±2.89)kg/m2],estimated glomerular filtration rate[(4.89±1.39)ml/(min·1.73m2)vs.(5.21±1.68)ml/(min·1.73m2)],and dosage(5g/10g/15g:4/4/4 cases vs.6/9/7cases).There was no statistically significant difference between the two groups(P＞0.05).In nine(75.0％)and four(18.2％)cases in the two groups respectively,serum potassium returned to normal 4 hours after medication,with statistically significant difference(x2=10.614,P=0.002).Whether blood potassium level returned to normal 4 hours after medication was significantly related to the baseline potassium level(r=0.483,P=0.001),but not to the dosage(r=0.118,P=0.474).No adverse effects such as hypokalemia,edema,nausea or vomiting occurred in all patients.Conclusions SZC can be safely and effectively applied to patients with mild hyperkalemia in the perioperative period of kidney transplantation to achieve rapid potassium reduction within 4 hours.
HyperkalemiaChronic kidney diseaseSodium zirconium cyclosilicateKidney transplantationPerioperative period
万方数据
维普
