# Patiromer verlaagt aldosteron bij CKD-patiënten met hyperkaliëmie op RAAS-remmers

*geplaatst 2016-09-01 · Hypertensie · Kidney international · doi 10.1016/j.kint.2016.04.019 · https://hartvaat.nl/2016/09/01/patiromer-verlaagt-aldosteron-bij-ckd-patienten-met-hyperkaliemie-op-raas-remmer/*

Studie die aantoont dat de kaliumverlager patiromer ook aldosteronniveaus verlaagt bij CKD-patiënten met hyperkaliëmie op RAAS-remmers. Dubbel mechanisme dat optimalisatie van RAAS-blokkade mogelijk maakt.

## English: Treatment with patiromer decreases aldosterone in patients with chronic kidney disease and hyperkalemia on renin-angiotensin system inhibitors.

This study showed that patiromer, in addition to lowering potassium, reduces aldosterone levels in CKD patients with hyperkalemia on RAAS inhibitor therapy, suggesting a secondary benefit through aldosterone suppression.

## Abstract (original, from the publication)

Elevated serum aldosterone can be vasculotoxic and facilitate cardiorenal damage. Renin-angiotensin system inhibitors reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia. Patiromer, a nonabsorbed potassium binder, decreases serum potassium in patients with chronic kidney disease on renin-angiotensin system inhibitors. Here we examined the effect of patiromer treatment on serum aldosterone, blood pressure, and albuminuria in patients with chronic kidney disease on renin-angiotensin system inhibitors with hyperkalemia (serum potassium 5.1-6.5 mEq/l). We analyzed data from the phase 3 OPAL-HK study (4-week initial treatment phase of 243 patients; 8-week randomized withdrawal phase of 107 patients). In the treatment phase, the (mean ± standard error) serum potassium was decreased concordantly with the serum aldosterone (-1.99 ± 0.51 ng/dl), systolic/diastolic blood pressure (-5.64 ± 1.04 mm Hg/-3.84 ± 0.69 mm Hg), and albumin-to-creatinine ratio (-203.7 ± 54.7 mg/g), all in a statistically significant manner. The change in the plasma renin activity (-0.44 ± 0.63 μg/l/hr) was not significant. In the withdrawal phase, mean aldosterone levels were sustained with patiromer (+0.23 ± 1.07 ng/dl) and significantly increased with placebo (+2.78 ± 1.25 ng/dl). Patients on patiromer had significant reductions in mean systolic/diastolic blood pressure (-6.70 ± 1.59/-2.15 ± 1.06 mm Hg), whereas those on placebo did not (-1.21 ± 1.89 mm Hg/+1.72 ± 1.26 mm Hg). Significant changes in plasma renin activity were found only in the placebo group (-3.90 ± 1.41 μg/l/hr). Thus, patiromer reduced serum potassium and aldosterone levels independent of plasma renin activity in patients with chronic kidney disease and hyperkalemia on renin-angiotensin system inhibitors.

Auteurs: Matthew R Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Yuri Stasiv, Jinwei Yuan, Lance Berman, Gordon H Williams

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Bron: Kidney international, https://doi.org/10.1016/j.kint.2016.04.019. Bijgewerkt 2026-07-03T18:38:26Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.