To observe the short-term potassium lowering effect of sodium zirconium cyclosilicate powder in patients with severe hyperkalemia of chronic kidney disease.

The clinical data of 11 patients with chronic kidney disease complicated with severe hyperkalemia who refused emergency hemodialysis and took sodium zirconium cyclosilicate powder in Yuebei People's Hospital from November 2020 to May 2021 were retrospectively analyzed, and the short-term treatment effect and drug safety were analyzed. Paired t test was used to compare the measurement data with normal distribution before and after medication. The correlation between potassium reduction range and intravenous potassium level before medication was analyzed by Pearson correlation analysis.

Among the 11 patients, 8 cases were male and 3 cases were female, aged (75.5±12.5) years; there were 10 cases (90.91%) with hypertension, 3 cases (27.27%) with diabetes, 1 case (9.09%) with coronary heart disease, and 1 case (9.09%) with heart failure; the estimated glomerular filtration rate (eGFR) was <15 ml·min^-1· (1.73 m²)^-1 in 7 cases (63.64%), and ≥15 ml·min^-1· (1.73 m²)-1 in 4 cases (36.36%). The intravenous potassium level of 11 patients was (7.02±0.54) mmol/L before medication, and (4.62±0.76) mmol/L in morning reexamination on the second day after medication, and the potassium reduction range on the first day was (2.40±0.43) mmol/L, with a statistically significant difference before and after medication (P<0.001). According to the initial intravenous potassium level, 4 patients in the ≥7.00 mmol/L group were decreased by (3.26±0.70) mmol/L on the first day, 7 patients in the 6.50-7.00 mmol/L group were decreased by (1.91±0.64) mmol/L on the first day; there was a statistically significant difference in the potassium reduction range between the two groups on the first day (P=0.024). The potassium reduction range on the first day was positively correlated with the level of intravenous potassium before medication (r=0.318, P=0.047). Hypokalemia occurred in 1 case and vomiting in 2 cases, and no other adverse reactions were found.

Sodium zirconium cyclosilicate powder can effectively reduce the blood potassium level in patients with chronic kidney disease and severe hyperkalemia within 24 hours, with high safety.

Hyperkalemia; Chronic kidney disease; Sodium zirconium cyclosilicate powder