Sodium Zirconium Cyclosilicate for Urgent Therapy of Severe Hyperkalemia

New England Journal of Medicine 372(16):1577 (2015) PMID 25875277

The authors of this letter report that in patients with severe hyperkalemia at baseline, treatment with a single dose of sodium zirconium cyclosilicate was associated a rapid and significant reduction in potassium as early as 1 hour after administration. To the Editor: Severe hyperkalemia (serum potassium level, ≥6 mmol per liter) can cause lethal cardiac arrhythmias and represents a medical emergency. Existing therapies do not remove excess potassium (intravenous calcium, bicarbonate, insulin, and dextrose and inhaled β-adrenergic agonists), have uncertain short-term efficacy and poor safety profiles (exchange resins), or are invasive and costly (emergency hemodialysis). We recently reported the results of two phase 3, randomized trials involving more than 1000 patients that indicated that sodium zirconium cyclosilicate (ZS-9) was effective in lowering the serum potassium level in a broad cross section of patients with hyperkalemia.1,2 In the total . . .

DOI: 10.1056/NEJMc1500353