Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials

Autores
Lizaraso Soto, Frank; Gutiérrez Abejón, Eduardo; Bustamante Munguira, Juan; Martín García, Débora; Chimeno, María Montserrat; Nava Rebollo, Álvaro; Maurtua Briseño Meiggs, Álvaro; Fernández, Darío; Bustamante Munguira, Elena; de Paz, Félix Jesús; Grande Villoria, Jesús; Ochoa Sangrador, Carlos; Pascual, Manuel; Álvarez, F. Javier; Herrera Gómez, Francisco
Año de publicación
2021
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., b-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serumpotassiumlevel (sK+) 3.5–5.0mEq/L) or acceptable kalemia (sK+ ≤5.1mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8–25.2 g/day (SUCRA = 0.94) and patiromer 8.4–16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc.
Fil: Lizaraso Soto, Frank. Universidad de Valladolid; España
Fil: Gutiérrez Abejón, Eduardo. Universidad de Valladolid; España
Fil: Bustamante Munguira, Juan. Universidad de Valladolid; España
Fil: Martín García, Débora. Universidad de Valladolid; España
Fil: Chimeno, María Montserrat. Hospital Virgen de la Concha; España
Fil: Nava Rebollo, Álvaro. Hospital Virgen de la Concha; España
Fil: Maurtua Briseño Meiggs, Álvaro. Woodland Medical Practicenhs; Reino Unido
Fil: Fernández, Darío. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Universidad Nacional de Cuyo; Argentina. Universidad de Burgos. Departamento de Didácticas Específicas; España
Fil: Bustamante Munguira, Elena. Universidad de Valladolid; España
Fil: de Paz, Félix Jesús. Universidad de Valladolid; España
Fil: Grande Villoria, Jesús. Universidad de Valladolid; España. Universite de Lausanne; Suiza
Fil: Ochoa Sangrador, Carlos. Sanidad de Castilla y León; España
Fil: Pascual, Manuel. Universite de Lausanne; Suiza
Fil: Álvarez, F. Javier. Universidad de Valladolid; España
Fil: Herrera Gómez, Francisco. Universite de Lausanne; Suiza. Universidad de Valladolid; España
Materia
HYPERKALEMIA
META-ANALYSIS (AS TOPIC)
MINERALOCORTICOID RECEPTOR ANTAGONISTS
NANOMEDICINE
POTASSIUM-BINDING POLYMERS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/152820
Acceder
id CONICETDig_f96ed171ac1186aa9f88b245c44d4ed4
oai_identifier_str oai:ri.conicet.gov.ar:11336/152820
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical TrialsLizaraso Soto, FrankGutiérrez Abejón, EduardoBustamante Munguira, JuanMartín García, DéboraChimeno, María MontserratNava Rebollo, ÁlvaroMaurtua Briseño Meiggs, ÁlvaroFernández, DaríoBustamante Munguira, Elenade Paz, Félix JesúsGrande Villoria, JesúsOchoa Sangrador, CarlosPascual, ManuelÁlvarez, F. JavierHerrera Gómez, FranciscoHYPERKALEMIAMETA-ANALYSIS (AS TOPIC)MINERALOCORTICOID RECEPTOR ANTAGONISTSNANOMEDICINEPOTASSIUM-BINDING POLYMERShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., b-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serumpotassiumlevel (sK+) 3.5–5.0mEq/L) or acceptable kalemia (sK+ ≤5.1mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8–25.2 g/day (SUCRA = 0.94) and patiromer 8.4–16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc.Fil: Lizaraso Soto, Frank. Universidad de Valladolid; EspañaFil: Gutiérrez Abejón, Eduardo. Universidad de Valladolid; EspañaFil: Bustamante Munguira, Juan. Universidad de Valladolid; EspañaFil: Martín García, Débora. Universidad de Valladolid; EspañaFil: Chimeno, María Montserrat. Hospital Virgen de la Concha; EspañaFil: Nava Rebollo, Álvaro. Hospital Virgen de la Concha; EspañaFil: Maurtua Briseño Meiggs, Álvaro. Woodland Medical Practicenhs; Reino UnidoFil: Fernández, Darío. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Universidad Nacional de Cuyo; Argentina. Universidad de Burgos. Departamento de Didácticas Específicas; EspañaFil: Bustamante Munguira, Elena. Universidad de Valladolid; EspañaFil: de Paz, Félix Jesús. Universidad de Valladolid; EspañaFil: Grande Villoria, Jesús. Universidad de Valladolid; España. Universite de Lausanne; SuizaFil: Ochoa Sangrador, Carlos. Sanidad de Castilla y León; EspañaFil: Pascual, Manuel. Universite de Lausanne; SuizaFil: Álvarez, F. Javier. Universidad de Valladolid; EspañaFil: Herrera Gómez, Francisco. Universite de Lausanne; Suiza. Universidad de Valladolid; EspañaFrontiers Media2021-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/152820Lizaraso Soto, Frank; Gutiérrez Abejón, Eduardo; Bustamante Munguira, Juan; Martín García, Débora; Chimeno, María Montserrat; et al.; Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials; Frontiers Media; Frontiers in Medicine; 8; 8-2021; 1-112296-858XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.3389/fmed.2021.686729info:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fmed.2021.686729/fullinfo:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416895/info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:45:56Zoai:ri.conicet.gov.ar:11336/152820instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:45:56.913CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
title Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
spellingShingle Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
Lizaraso Soto, Frank
HYPERKALEMIA
META-ANALYSIS (AS TOPIC)
MINERALOCORTICOID RECEPTOR ANTAGONISTS
NANOMEDICINE
POTASSIUM-BINDING POLYMERS
title_short Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
title_full Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
title_fullStr Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
title_full_unstemmed Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
title_sort Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials
dc.creator.none.fl_str_mv Lizaraso Soto, Frank
Gutiérrez Abejón, Eduardo
Bustamante Munguira, Juan
Martín García, Débora
Chimeno, María Montserrat
Nava Rebollo, Álvaro
Maurtua Briseño Meiggs, Álvaro
Fernández, Darío
Bustamante Munguira, Elena
de Paz, Félix Jesús
Grande Villoria, Jesús
Ochoa Sangrador, Carlos
Pascual, Manuel
Álvarez, F. Javier
Herrera Gómez, Francisco
author Lizaraso Soto, Frank
author_facet Lizaraso Soto, Frank
Gutiérrez Abejón, Eduardo
Bustamante Munguira, Juan
Martín García, Débora
Chimeno, María Montserrat
Nava Rebollo, Álvaro
Maurtua Briseño Meiggs, Álvaro
Fernández, Darío
Bustamante Munguira, Elena
de Paz, Félix Jesús
Grande Villoria, Jesús
Ochoa Sangrador, Carlos
Pascual, Manuel
Álvarez, F. Javier
Herrera Gómez, Francisco
author_role author
author2 Gutiérrez Abejón, Eduardo
Bustamante Munguira, Juan
Martín García, Débora
Chimeno, María Montserrat
Nava Rebollo, Álvaro
Maurtua Briseño Meiggs, Álvaro
Fernández, Darío
Bustamante Munguira, Elena
de Paz, Félix Jesús
Grande Villoria, Jesús
Ochoa Sangrador, Carlos
Pascual, Manuel
Álvarez, F. Javier
Herrera Gómez, Francisco
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv HYPERKALEMIA
META-ANALYSIS (AS TOPIC)
MINERALOCORTICOID RECEPTOR ANTAGONISTS
NANOMEDICINE
POTASSIUM-BINDING POLYMERS
topic HYPERKALEMIA
META-ANALYSIS (AS TOPIC)
MINERALOCORTICOID RECEPTOR ANTAGONISTS
NANOMEDICINE
POTASSIUM-BINDING POLYMERS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., b-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serumpotassiumlevel (sK+) 3.5–5.0mEq/L) or acceptable kalemia (sK+ ≤5.1mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8–25.2 g/day (SUCRA = 0.94) and patiromer 8.4–16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc.
Fil: Lizaraso Soto, Frank. Universidad de Valladolid; España
Fil: Gutiérrez Abejón, Eduardo. Universidad de Valladolid; España
Fil: Bustamante Munguira, Juan. Universidad de Valladolid; España
Fil: Martín García, Débora. Universidad de Valladolid; España
Fil: Chimeno, María Montserrat. Hospital Virgen de la Concha; España
Fil: Nava Rebollo, Álvaro. Hospital Virgen de la Concha; España
Fil: Maurtua Briseño Meiggs, Álvaro. Woodland Medical Practicenhs; Reino Unido
Fil: Fernández, Darío. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Universidad Nacional de Cuyo; Argentina. Universidad de Burgos. Departamento de Didácticas Específicas; España
Fil: Bustamante Munguira, Elena. Universidad de Valladolid; España
Fil: de Paz, Félix Jesús. Universidad de Valladolid; España
Fil: Grande Villoria, Jesús. Universidad de Valladolid; España. Universite de Lausanne; Suiza
Fil: Ochoa Sangrador, Carlos. Sanidad de Castilla y León; España
Fil: Pascual, Manuel. Universite de Lausanne; Suiza
Fil: Álvarez, F. Javier. Universidad de Valladolid; España
Fil: Herrera Gómez, Francisco. Universite de Lausanne; Suiza. Universidad de Valladolid; España
description This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., b-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serumpotassiumlevel (sK+) 3.5–5.0mEq/L) or acceptable kalemia (sK+ ≤5.1mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8–25.2 g/day (SUCRA = 0.94) and patiromer 8.4–16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc.
publishDate 2021
dc.date.none.fl_str_mv 2021-08
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/152820
Lizaraso Soto, Frank; Gutiérrez Abejón, Eduardo; Bustamante Munguira, Juan; Martín García, Débora; Chimeno, María Montserrat; et al.; Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials; Frontiers Media; Frontiers in Medicine; 8; 8-2021; 1-11
2296-858X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/152820
identifier_str_mv Lizaraso Soto, Frank; Gutiérrez Abejón, Eduardo; Bustamante Munguira, Juan; Martín García, Débora; Chimeno, María Montserrat; et al.; Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials; Frontiers Media; Frontiers in Medicine; 8; 8-2021; 1-11
2296-858X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.3389/fmed.2021.686729
info:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fmed.2021.686729/full
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416895/
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1844614499880927232
score 13.070432

Publicaciones similares