RT info:eu-repo/semantics/article
T1 Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
A1 Lizaraso-Soto, Frank
A1 Gutiérrez-Abejón, Eduardo
A1 Bustamante-Munguira, Juan
A1 Martín-García, Débora
A1 Chimeno, María Montserrat
A1 Nava-Rebollo, Álvaro
A1 Maurtua-Briseño-Meiggs, Álvaro
A1 Fernández-Zoppino, Darío
A1 Bustamante-Munguira, Elena
A1 de Paz, Félix Jesús
A1 Grande-Villoria, Jesús
A1 Ochoa-Sangrador, Carlos
A1 Pascual, Manuel
A1 Álvarez, F. Javier
A1 Herrera-Gómez, Francisco
K1 hyperkalemia; meta-analysis (as topic); mineralocorticoid receptor antagonists; nanomedicine; potassium-binding polymers
AB 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.
PB Trials. Front. Med.
YR 2021
FD 2021
LK https://uvadoc.uva.es/handle/10324/82046
UL https://uvadoc.uva.es/handle/10324/82046
LA eng
NO 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. (2021). Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials. Frontiers in medicine, 8, 686729. https://doi.org/10.3389/fmed.2021.686729
NO Producción Científica
DS UVaDOC
RD 23-ene-2026