Hyperkalemia in heart failure: etiology, epidemiology and prognosis
L'iperpotassiemia nello scompenso cardiaco: eziologia, epidemiologia e prognosi

Simona Romani, Gianfranco Sinagra
2021
Hyperkalemia (HK) is a common condition among heart failure (HF) patients, either due to their comorbidities, such as chronic renal failure, or due to the administration of therapies capable of promoting an increase in serum potassium (K+), such as renin-angiotensin-aldosterone system inhibitors (RAASi). RAASi are among the most important treatments for HF, especially in patients with reduced ejection fraction. This class of drugs, acting on the neurohormonal mechanisms, that lead to the
more » ... ng of hemodynamic compensation, has shown to improve the prognosis of HF patients, both in terms of mortality and HF hospitalizations. HK is a major cause of dose reduction, or even discontinuation, of RAASi, thus, indirectly worsening HF patient's prognosis. Pharmacological strategies for HK treatment in outpatients have long been based solely on therapies of dubious efficacy, such as sodium polystyrene sulfonate, which are difficult to administer in an extended period of time. Reasonably, the use of the new K+ binders (patiromer and sodium zirconium cyclosilicate) in clinical practice, allowing to reduce serum K+ levels without discontinuing RAASi therapy, will improve the prognosis of patients with HK and HF.
doi:10.1714/3716.37067 pmid:34935773 fatcat:elfvdzmowbgkjopb6wqujaa3zq