Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSRIC. Sodium Zirconium cyclosilicate for hyperkalaemia – first line. Birmingham: NIHR Horizon Scanning Research&Intelligence Centre. Horizon Scanning Review. 2015 Authors' objectives Sodium zirconium cyclosilicate is a potassium binder that is intended for the treatment of hyperkalaemia. Hyperkalaemia, the term used to describe excess serum potassium, predominantly affects those with acute or chronic kidney failure. This condition causes rapid reduction in resting membrane potential, which can lead to increased cardiac depolarisation and muscle excitability, which in turn leads to electrocardiographic (EGG) changes. At levels above 6.5mmol/L, the risk of ventricular fibrillation or asystole increases quickly.
The majority of cases of hyperkalaemia are observed in those patients prescribed angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), often in conjunction with spironolactone in those with pre-existing or new renal impairment.
Hyperkalaemia occurs in up to 10% of hospitalised patients, of which 77% of cases are thought to be due to renal failure and 63% to prescribed drugs. In 2012-13, there were 6,344 admissions for hyperkalaemia in England, resulting in 20,457 bed-days and 8,662 finished consultant episodes.
The treatment of hyperkalaemia involves the removal of any precipitating drugs and reduction of excess potassium from fluids or food. Calcium gluconate is given to reduce cardiac cell membrane excitability. To help shift potassium from the extracellular domain to the intracellular space, patients may be given a rapid acting insulin (with glucose to avoid hypoglycaemia) or nebulised salbutamol, although the response is not always consistent. Some patients may be given ion-exchange resins, such as polystyrene sulfonate resins (for example calcium resonium) to remove serum potassium from the body. Those patients that do not respond to these treatments, or are on long term dialysis or with advanced chronic kidney disease will require dialysis.
Sodium zirconium cyclosilicate is currently in one phase III clinical trial testing the safety and efficacy of its long term use. This trial is expected to complete in August 2016. Final publication URL www.hsric.nihr.ac.uk/topics/sodium-zirconium-cyclosilicate-for-hyperkalaemia-first-line/ Indexing Status Subject indexing assigned by CRD MeSH Humans; Hyperkalemia; Silicates Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NIHR Horizon Scanning Research&Intelligence Centre, University of Birmingham, Institute of Applied Health Research, Public Health building, Edgbaston, Birmingham B15 2TT
Tel: 0121 414 9077 Email: nihrhsc@contacts.bham.ac.uk AccessionNumber 32016000341 Date abstract record published 03/03/2016 |