{"id":"72f267b9d51d","type":"article","url":"https://hartvaat.nl/2018/08/01/langetermijn-patiromer-bij-hyperkaliemie-met-mild-hf-en-diabetische-nefropathie/","title":"Langetermijn patiromer bij hyperkaliëmie met mild HF en diabetische nefropathie","title_en":"Long-term effects of patiromer for hyperkalaemia treatment in patients with mild heart failure and diabetic nephropathy on angiotensin-converting enzymes/angiotensin receptor blockers: results from AMETHYST-DN.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["anemie-ckd","chronische-nierziekte","diabetische-nefropathie"],"journal":"ESC heart failure","doi":"10.1002/ehf2.12292","source_url":"https://doi.org/10.1002/ehf2.12292","authors":["Bertram Pitt","George L Bakris","Matthew R Weir","Mason W Freeman","Mitja Lainscak","Martha R Mayo","Dahlia Garza","Rezi Zawadzki","Lance Berman","David A Bushinsky"],"significance":6,"published":"2018-08-01","source_date":"2018-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/digoxine-bij-hartfalen/","https://hartvaat.nl/kennis/farmacologie/aldosteron-en-raas-farmacologie/"],"congress":"","summary_en":"This study evaluated long-term patiromer effects on potassium levels and RAAS inhibitor use in patients with mild heart failure and diabetic nephropathy, demonstrating sustained potassium management that enables optimal neurohormonal blockade.","created":"2026-07-03T10:27:24Z","updated":"2026-07-03T13:26:38Z","licence":"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.","body_markdown":"Studie naar langetermijneffecten van patiromer op kaliumniveaus en RAAS-remmergebruik bij patiënten met mild hartfalen en diabetische nefropathie.","abstract_original":"AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5.0-5.5 mmol/L (mild) or >5.5-<6.0 mmol/L (moderate)], with or without HF (New York Heart Association Class I and II, by investigator judgement), on ACE-I/ARB, were randomized to patiromer 8.4-33.6 g to start, divided twice daily. Overall, 105/304 (35%) patients had HF (75%, Class II). Mean (standard deviation) ejection fraction (EF) was 44.9% (8.2) (n = 81) in patients with HF; 26 had EF ≤40%. In HF patients, mean serum potassium decreased by Day 3 through Week 52. At Week 4, estimated mean (95% confidence interval) change in serum potassium was -0.64 mmol/L (-0.72, -0.55) in mild and -0.97 mmol/L (-1.14, -0.80) in moderate HK (both P < 0.0001). Most HF patients with mild (>88%) and moderate (≥73%) HK had normokalaemia at each visit from Weeks 12 to 52. Three HF patients were withdrawn because of high (n = 1) or low (n = 2) serum potassium. The most common patiromer-related adverse event was hypomagnesaemia (8.6%). CONCLUSIONS: In patients with a clinical diagnosis of HF, diabetes, CKD, and HK on ACE-I/ARB, patiromer was well tolerated and effective for HK treatment over 52 weeks."}