Supported by educational grants from Abbott, AstraZeneca, Bayer, Chiesi, NovoNordisk. This program is intended for healthcare providers.
— cardio-met (@cardiomet_CE) June 15, 2021
3) Risk Factors for #hyperkalemia include: Advanced stages of #CKD, #heartfailure, resistant #hypertension, #diabetes, myocardial infarction (#MI), and/or, combinations of these conditions (https://t.co/i5ytAJEzUs, https://t.co/rKUiWrKjoV, https://t.co/BEJAEpIHye)
— cardio-met (@cardiomet_CE) June 15, 2021
— cardio-met (@cardiomet_CE) June 15, 2021
— cardio-met (@cardiomet_CE) June 15, 2021
7) RAASi are recommended for patients with hypertension, HF, stable coronary artery disease, CKD, diabetic kidney disease (#DKD), and diabetes. They improve survival in patients with CKD, HF, and post-MI status and also provide kidney benefits in patients with non-DKD and DKD.
— cardio-met (@cardiomet_CE) June 15, 2021
9) What are the treatment options for the management of his hyperkalemia?
— cardio-met (@cardiomet_CE) June 15, 2021
A. Diet
B. Removal of other hyperkalemia-causing drugs
C. Use of diuretics
D. Modification of RAASi dose
E. K+ binders
11) Welcome back! There's more to go on managing #hyperkalemia with the latest, safest options. I'm @edgarvlermamd. Encourage your colleagues, fellows, and residents to follow us here at @cardiomet_CE for serialized Twitter-based accredited education!
— cardio-met (@cardiomet_CE) June 16, 2021
13) A low-K+ diet is difficult for patients to adhere to, particularly those who may have additional dietary restrictions due to #diabetes and reduced sodium intake for CKD or #heartfailure. pic.twitter.com/i4S0NkNECS
— cardio-met (@cardiomet_CE) June 16, 2021
— cardio-met (@cardiomet_CE) June 16, 2021
16) Despite beneficial effects of diuretics on volume status and BP, they may increase the risk of gout, volume depletion, decreased distal tubule flow, worsening kidney function, & reduced K+ excretion. Their effectiveness in managing hyperK+ relies on residual kidney function.
— cardio-met (@cardiomet_CE) June 16, 2021
18) Discontinuation or dose reduction of #RAASi therapy may lead to adverse cardiorenal outcomes, and current guidelines differ with regard to recommendations on when to reinitiate RAASi. pic.twitter.com/VcsRVeMetW
— cardio-met (@cardiomet_CE) June 16, 2021
20) K+ binders used for hyperkalemia management are nonabsorbed and consist of a counter ion that is exchanged for K+ facilitating the elimination of bound K+ in the feces. pic.twitter.com/omdjZxebS6
— cardio-met (@cardiomet_CE) June 16, 2021
21) Sodium polystyrene sulfonate (SPS) is the K+ binder that has been available for hyperkalemia management for the longest time, and may continue to be the only agent available in parts of the world. pic.twitter.com/d0kO9T2wxF
— cardio-met (@cardiomet_CE) June 16, 2021
22) SPS is a polymeric cation-exchange resin that binds K+ ions in exchange for Na+ ions in the distal colon. It is nonselective for K+, with affinity for Ca2+ and Mg2+ ions. It may be given either orally or rectally (oral has poor palatability).
— cardio-met (@cardiomet_CE) June 16, 2021
24) Two novel oral K+ binders are now approved in the US and the European Union: Patiromer sorbitex calcium and Sodium zirconium cyclosilicate (SZC; [formerly ZS-9]). pic.twitter.com/PtLb2NlV7F
— cardio-met (@cardiomet_CE) June 16, 2021
26) Mark your answer and return tomorrow for a detailed exploration of these new binders and a link to your free CE/#CME! @dr_nikhilshah @RenalFellowNtwk @HecmagsMD @Nephro_Sparks @AnnaGaddy @PharmERToxGuy @AliMehdiMD @ISNkidneycare @beaverspharmd @JamesNovakNeph
— cardio-met (@cardiomet_CE) June 16, 2021
28) Oral patiromer contains a Ca2+ sorbitol counterion that exchanges Ca2+ for K+ as it passes through the colon. Like SPS, it is a polymer that is nonselective for K+ and may also bind Mg2+ and small amounts of Na+.
— cardio-met (@cardiomet_CE) June 17, 2021
30) Unlike SPS and patiromer, SZC is nonpolymeric with high selectivity for K+ and NH4+ ions (1.25-fold higher affinity for K+ vs NH4+) in exchange for H+ and Na+ throughout the GIT. SZC binds monovalent cations (K+) as opposed to divalent cations (e.g., Ca2+ and Mg2+).
— cardio-met (@cardiomet_CE) June 17, 2021
32) Look at the clinical evidence supporting these K+ binders pic.twitter.com/0hH4taSgph
— cardio-met (@cardiomet_CE) June 17, 2021
32) Look at the clinical evidence supporting these K+ binders pic.twitter.com/0hH4taSgph
— cardio-met (@cardiomet_CE) June 17, 2021
— cardio-met (@cardiomet_CE) June 17, 2021
— cardio-met (@cardiomet_CE) June 17, 2021
— cardio-met (@cardiomet_CE) June 17, 2021
36) The most common AEs associated with patiromer therapy include gastrointestinal events (constipation, diarrhea, nausea/ vomiting, abdominal discomfort, and flatulence) and electrolyte disturbances (hypokalemia and hypomagnesemia) . . . as per
— cardio-met (@cardiomet_CE) June 17, 2021
— cardio-met (@cardiomet_CE) June 17, 2021
— cardio-met (@cardiomet_CE) June 17, 2021
41) Here’s a nice algorithm to follow in the management of chronic hyperkalemia. pic.twitter.com/Lt7CtWldTa
— cardio-met (@cardiomet_CE) June 17, 2021
42) That's it! You made it! Free CE/#CME! Now, all you #physicians, #nurses, and #pharmacists, go to https://t.co/TKBRtNxElG and claim your credit from @academiccme! I am @edgarvlermamd. Follow @cardiomet_CE for more tweetorials! #medtwittter #nephtwitter @MedTweetorials #FOAMed
— cardio-met (@cardiomet_CE) June 17, 2021