• Internal medicine · Jan 2021

    Case Reports

    Combination Therapy Using Sodium Zirconium Cyclosilicate and a Mineralocorticoid Receptor Antagonist in Patients with Heart Failure and Hyperkalemia.

    • Teruhiko Imamura, Akira Oshima, Nikhil Narang, Ryuichi Ushijima, Yohei Ueno, Hiroshi Ueno, and Koichiro Kinugawa.
    • The Second Department of Internal Medicine, University of Toyama, Japan.
    • Intern. Med. 2021 Jan 1; 60 (13): 2093-2095.

    AbstractHyperkalemia is a challenging comorbidity to manage in patients with heart failure and chronic kidney disease, particularly when administering renin-angiotensin-aldosterone system inhibitors. We encountered an 88-year-old woman with hypertensive heart failure and chronic kidney disease. A mineralocorticoid receptor antagonist was able to be safely administered despite persistent hyperkalemia when sodium zirconium cyclosilicate, a non-absorbed, non-polymer zirconium silicate compound that preferentially exchanges hydrogen and sodium for potassium and ammonium ions in the gastrointestinal tract, was concomitantly administered. Sodium zirconium cyclosilicate might be a promising therapeutic tool to use in order to administer mineralocorticoid receptor antagonist safely in patients with heart failure, chronic kidney disease, and hyperkalemia.

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