22 Hyperkalemia rates reported in observational studies vary by patient population (Table S1 in the online-only Data Supplement). Given that both patiromer and SZC are simply administered, well tolerated, safe, and effective, health care providers now have two viable choices to consider for long-term management of hyperkalemia. The rate of hyperkalemia is low in uncomplicated hypertension patients treated with RAASi, 21 but it rises in the setting of other comorbidities (eg, eGFR <60 and especially <45 mL/min per 1.73 m 2, and heart failure) or dual RAAS inhibition. Prior history of hypersensitivity to a RAASi drug, including but not limited to development of angioedema, icterus, hepatitis, or neutropenia or thrombocytopenia requiring treatment modification. Overview of Hyperkalemia. Renin-angiotensin-aldosterone system inhibitors. A rise in potassium level represents a frequent cause for RAASi dose reduction or discontinuation—actions that may deprive patients of therapy proven to improve clinical outcomes. What does RAASi mean in Drugs? Reported percentages of RAASi therapy (single or dual) discontinuation due to hyperkalemia from randomized trials of various patient groups (e.g. According to the ESC expert consensus document, when hyperkalemia develops, it is recommended that patients’ potassium level is lowered to enable them to continue their RAASi therapy. We concluded that individual therapy resistance to RAASi cannot be overcome with the addition of a completely different class of drugs, SGLT2 inhibitors. hypertension or heart failure) have been relatively low (0.4–8.1% [3,20]) while data on the patterns of RAASi therapy following hyperkalemia in CKD in routine clinical settings are limited. In this analysis of adult RAASi users with CKD, hyperkalemia and subsequent RAASi treatment changes were common. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP … Addison's disease or other causes of hypoaldosteronism. Discontinuation or dose reduction of RAASi therapy may lead to adverse cardiorenal outcomes, and current guidelines differ with regard to recommendations on when to reinitiate RAASi . This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Among patients who experienced incident hyperkalemia, 46.6% had changes made to their RAASi treatment regimen following the first occurrence of hyperkalemia (discontinuation: 36.6% and dose reduction: 10.0%). Add to My List Edit this Entry Rate it: (0.00 / 0 votes) Receiving dialysis or anticipated by the investigator to require dialysis therapy within 3 months. Medical » Drugs. 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