Background and Importance Sodium zirconium cyclosilicate (SZC) is used to correct hyperkalaemia (K>5.1 mEq/L). SZC should be administered to patients who have not responded well or have become intolerant to alternative treatments, such as resins, using an initial dose of 10mg/8h followed by a maintenance dose of either 5 mg or 10mg every 24h. Real clinical data of use might be required to optimise this treatment.

Aim and Objectives To describe effectiveness and use of SZC for the treatment of hyperkalaemia in hospitalised patients with an initial or maintenance starting dose.

Material and Methods Retrospective descriptive study was designed in hospitalised patients who started treatment with SZC between July 2021 and July 2023. Outcomes were collected from medical records and electronic prescription software: gender, age, initial dose and/or maintenance dose, serum potassium concentrations (at 0, 48 and 72 hours after starting SZC treatment) and previous use of exchange resins like calcium polystyrene sulfonate (CPS). The effectiveness endpoint was described as: percentage of patients who achieved a normal serum potassium level (3.5–5 mEq/L) at 48 and 72 h, with either initial or maintenance starting dose.

Results There were 35 patients (62.2% male and 37.8% female) that presented a mean age of 69 (34–96) years. Initial dose of 10 mg/8h were used in 29.7% of patients. Maintenance dose of 5 mg/24h were used as starting dose in 64.9% of patients and 10 mg/24h in 35.1%. Starting serum potassium concentration mean was 6.3 mEq/L (5.2–9.8). In terms of use, CPS were previously used in 43.2% of patients. About effectiveness results at 48h, 60% of patients reached normal potassium concentrations, 72.7% received the initial starting dose while 54.2% did not received the initial starting dose. At 72h, 80% of patients reached normal potassium concentrations, 90.9% received the initial starting dose while 75% did not receive the initial starting dose.

Conclusion and Relevance SZC therapy displayed that more than 50% of patients achieved normal potassium levels at 48 and 72h with both regimens. Starting SZC therapy with the initial starting dose showed better and faster effectiveness. More than half of the patients had not previously tried CPS, the most cost-effectiveness option.

Conflict of Interest No conflict of interest.