부산대학교 도서관

Introduction: Medical nutrition therapy (MNT) slows chronic kidney disease (CKD) progression but its effect on serum potassium (K) and hyperkalemia (HK) recurrence in patients with heart failure (HF) and comorbid CKD is unclear. REVOLUTIONIZE I is a real-world study of HK recurrence in patients who received MNT after experiencing HK.Aims: This analysis aims to describe HK recurrence in a subgroup of patients with HF and comorbid CKD in the REVOLUTIONIZE I study.Methods: Patients aged ≥18 years with HF and stage 3/4 CKD who received MNT within 30 days after a serum K value of >5.0 mEq (1/1/2019 to 10/31/22) were identified from TriNetX Dataworks de-identified electronic health records data. Patients were excluded if they received outpatient K binder therapy within 6 months before the index date (MNT date + 7 days). Patients were censored at the first of: 6 months post-index, outpatient K binder therapy initiation, death, or 10/31/22. HK recurrence was calculated for 1-6-month intervals post-index and compared with the estimated a priori HK recurrence rate (50%) by Chi-square test.Results: The HF subgroup included 1179 patients. Of 861 patients with ≥6 months’ follow-up, 485 (56.3%) had ≥1 HK recurrence (Figure), with a mean ± SD of 2.6 ± 2.2 recurrences (range 1-14). Time between HK recurrences decreased with each recurrence, from a mean of 42 days for the first recurrence to 35 days for the second and <30 days for additional recurrences.Conclusions: This real-world study showed that HK is a chronic, recurrent condition for the majority of patients with HF and comorbid CKD, despite the use of medical nutrition therapy. There is unmet need to consider long-term anti-HK therapy with newer K binders to reduce HK recurrence in this patient population.