Table 3.
Main characteristics of the approved potassium binders for the treatment of hyperkalemia.
| Drug, FDA Approval |
Mechanisms Location |
Onset of Action | Patient Groups Tested in Clinical Trials | Adverse Effects | Cost |
|---|---|---|---|---|---|
| SPS, 1958 |
Non-specific organic ion-exchange resin. It exchanges sodium for Potassium. Colon |
Variable, hours to days [39] |
CKD, HD | Mild to moderate gastrointestinal effects, including colonic necrosis, poor tolerability, electrolyte disorders |
Low |
| Patiromer, 2015 |
Non-specific organic ion-exchange resin. It exchanges calcium for potassium. Colon |
Within 7 h [51] | CHF, Diabetes, CKD +/- mRAASi |
Mild gastrointestinal effects, hypomagnesaemia, hypokalemia (3–6%) |
Very high |
| SZC, 2018 |
Selective inorganic non-polymer. It exchanges sodium and hydrogen for potassium. Entire gastrointestinal tract |
Median time 2 h [69] | CHF, CKD, HD ED +/- RAASi |
Mild gastrointestinal effects, oedema and hypokalemia (dose-dependent) |
Very high |
Abbreviations: SPS, Sodium Polystyrene Sulfonate; SZC, Sodium Zirconium Cyclosilicate; CHF, Chronic heart failure; CKD, Chronic Kidney Disease; HK, Hyperkalemia; RAASi, Renin-Angiotensin-Aldosterone system inhibitors; ED, Emergency Department; HD, hemodialysis.