Single Center Retrospective Study Examining the Safety of the New Potassium- Binders for Post-Operative Hyperkalemia in Kidney Transplant Recipients

S. Kapoor¹, A. Campbell², Y. Azzi¹, L. E. Liriano-Ward³, T. Shertel⁴, W. Xiao⁵, D. U. Nnani⁶, S. Farghaly¹, S. Yun⁷, E. Akalin¹, M. Ajaimy¹

¹Einstein-Montefiore Transplant Center, Bronx, NY, ²Montefiore Medical Center, Bronx, NY, ³Transplant, Montefiore Medical Center, Bronx, NY, ⁴-, -, AL, ⁵Albert Einstein College of Medicine, Folsom, CA, ⁶Pharmacy, Montefiore Medical Center, Bronx, NY, ⁷Montefiore Medical Center, New York, NY

Meeting: 2022 American Transplant Congress

Abstract number: 774

Keywords: Kidney transplantation, Metabolic complications, Safety

Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications

Session Information

Session Name: Kidney: Cardiovascular and Metabolic Complications

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: We aimed to evaluate the safety and efficacy of two potassium-binders (Patiromer and Sodium Zirconium Cyclosilicate (SZC) in early post-transplant hyperkalemia treatment of kidney transplant recipients.

*Methods: This is a retrospective, single-center, cohort study of isolated deceased- kidney transplants performed at our center between January 2018 and December 2020. Inpatient potassium-binder use was evaluated from the time of transplant until the patients were discharged from hospital. Binders were given at least 2 hours before or 2 hours after other medications.

*Results: 241 kidney transplant patients were included in our study. A total of 42 patients (17.4%) received a potassium binder [31 (12.86%) received Patiromer, and 11(4.56%) received SZC]. Delayed Graft function (DGF) requiring dialysis within 7 days after transplantation observed in 121 recipients (52.3%). Of the 121 patients with DGF, 30 (24.8%) received a potassium binder and 91 (75.2%) patients did not. In patients with DGF, the mean peak potassium was higher in the K binders’ patients when compared to non-binders’ ones (6.09 vs 5.60, p=0.0005), the number of dialysis sessions were also higher in the binders group vs non binders (3.5 vs. 2.5, P=0.04), mostly confounded by allograft function. In patients with no DGF, the mean potassium peak was also higher in the binder’s patient when compared to the patients who did not receive binders (5.75 vs. 5.1, p=0.002). The mean potassium on discharge was comparable in the patients that did and did not receive a K-binder (4.2 vs 4.3, p-0.1). GI symptoms (diarrhea or nausea) were reported in 5 patients (11.9%) of patients who received potassium binders compared to 35(17.5%) of the patients who did not (p=0.3). There were no reports of GI perforation related to potassium binder use

*Conclusions: The use of the new potassium lowering agents appears to be safe in the early post-transplant period. The use of potassium binders does not appear to be associated with reduced number of dialysis sessions in patients with DGF however can be used as an additional tool for potassium lowering in this patient population

To cite this abstract in AMA style:

Kapoor S, Campbell A, Azzi Y, Liriano-Ward LE, Shertel T, Xiao W, Nnani DU, Farghaly S, Yun S, Akalin E, Ajaimy M. Single Center Retrospective Study Examining the Safety of the New Potassium- Binders for Post-Operative Hyperkalemia in Kidney Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/single-center-retrospective-study-examining-the-safety-of-the-new-potassium-binders-for-post-operative-hyperkalemia-in-kidney-transplant-recipients/. Accessed May 17, 2025.

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