Potassium Binder May Ease Potassium Restriction During Dialysis
Dietary potassium restriction is important for managing hyperkalaemia, or high blood potassium levels, in individuals on maintenance haemodialysis, but it imposes a substantial day-to-day burden. Results from a recent clinical trial indicate that adding the potassium binder sodium zirconium cyclosilicate (SZC) may help. The findings were published in BMC Nephrology and also presented at American Society of Nephrology (ASN) Kidney Week 2026 October 22–25.
In the multicentre, randomised, open-label, parallel-group trial, outpatients receiving thrice-weekly maintenance haemodialysis with pre-dialysis serum potassium of 5.5 to < 6.5 mEq/L were assigned to SZC plus standardised nutritional counselling or nutritional counselling alone for 8 weeks.
In the main analysis including 183 patients, those who received SZC plus standardised nutrition counselling had a greater improvement in quality of life related to dietary potassium restriction than those who received nutrition counselling alone. SZC also lowered pre-dialysis serum potassium more effectively. No patient in the SZC group needed rescue treatment during the 8-week study, compared with 25 of 92 patients in the control group. In exploratory analyses, the investigators also saw an increase in fruit intake without an increase in total dietary potassium intake, as well as improvements in several areas of kidney disease-related quality of life. There were no serious treatment-related adverse events or deaths.
“SZC may provide an important patient-centred benefit beyond lowering serum potassium. When added to standardised nutritional counselling and regular potassium monitoring, SZC reduced the day-to-day burden of dietary potassium restriction while also providing better potassium control,” said corresponding author Hiromichi Wakui, MD, PhD, of Yokohama City University Graduate School of Medicine. “Hyperkalaemia treatment should be judged not only by whether the potassium level falls, but also by whether treatment makes daily life less burdensome for patients.”
The investigators stressed that individualised dietary assessment, regular potassium monitoring, and attention to overall nutritional quality remain essential. When dietary restriction alone places a substantial burden on patients, potassium-binding therapy may support a safer and more patient-cantered management strategy.”
Source: American Society of Nephrology
