Intermittent sodium zirconium cyclosilicate Treatment May Prevent Hyperkalemia in CKD Patients: Study

In a retrospective study, we analyzed patients in the Hospital Authority Clinical Data Analysis and Reporting System (CDARS) receiving sodium zirconium cyclosilicate (Lokelma®) therapy once to thrice weekly for at least 3 months from January 2021 to June 2023. Outcome measures included plasma potassium levels, hyperkalemia episodes, hospital admissions, and renal function changes, which were compared to the 6 months period before the initiation of SZC treatment.

Results: They studied 36 adult CKD patients. SZC treatment significantly reduced plasma potassium levels from 5.10 (inter-quartile range [IQR] 4.91–5.40) to 4.73 (IQR 4.50–5.10) mmol/l (p = 0.0003). The median incidence of any hyperkalemia reduced from 5.0 (IQR 2.0–8.0) to 1.9 (IQR 0.0–4.7) episode per patient-year (p = 0.0001), and the incidence of urgent treatment for hyperkalemia decreased from 2.0 (IQR 0.0–4.0) to 0.0 (IQR 0.0–1.5) episode per patient-year (p = 0.007).

The number of emergency room attendance and hospitalization were not significantly reduced. Intermittent SZC treatment may help prevent hyperkalemia in CKD patients. Further research is necessary to ascertain if this benefit translates into impro

Reference:

Ng, J.KC., Fung, WS., Chan, GK. et al. Intermittent sodium zirconium cyclosilicate for the prevention of hyperkalemia in chronic kidney disease. BMC Nephrol 26, 260 (2025). https://doi.org/10.1186/s12882-025-04194-0