Patiromer Efficacy across Kidney Function and Hyperkalemia Subgroups in Heart Failure and Reduced Ejection Fraction
Abstract
L L mL/min/1.73m2 and hyperkalemia (-0.28 mEq/L, 95% CI -0.38 to -0.18, P<0.001) and the smallest in those with eGFR ≥45 mL/min/1.73m2 and normokalemia (-0.08 mEq/L, 95% CI -0.12 to -0.04, P<0.001; Pinteraction <0.001). Patiromer reduced time-to-first hyperkalemia consistently across subgroups. Patients with eGFR <45 mL/min/1.73m2 and baseline hyperkalemia derived the numerically greatest effect in prevention of mineralocorticoid receptor antagonist down-titration (hazard ratio 0.39, 95% CI 0.18-0.84, P=0.02) and had the highest win ratio for hyperkalemia-related morbidityadjusted outcomes (3.03, 95% CI 1.96-4.70, P<0.001). However, Pinteraction values for these secondary endpoints were not statistically significant. Conclusions: Patiromer reduced serum potassium across baseline kidney function and hyperkalemia subgroups, with greater effect in patients with reduced kidney function and baseline hyperkalemia. These findings suggest potential heterogeneity in potassium-lowering effects of patiromer across subgroups, although the analysis is exploratory and should be considered hypothesis-generating.
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BibTeX
@article{kalogeropoulos2026patiromer,
title = {{Patiromer Efficacy across Kidney Function and Hyperkalemia Subgroups in Heart Failure and Reduced Ejection Fraction}},
author = {Andreas P Kalogeropoulos and Ahmed Mustafa Rashid and Stefan D Anker and Antoni Bayes-Genis and Michael Böhm and Jeffrey Budden and John G F Cleland and Andrew J S Coats and Justin A Ezekowitz and Gerasimos Filippatos and Assen Goudev and Muhammad Shahzeb Khan and Joann Lindenfeld and Lars H Lund and Bela Merkely and Robert J Mentz and Marco Metra and Jude Moutchia and Piotr Ponikowski and Patrick Rossignol and Michele Senni and Sandra Waechter and Matthew R Weir and Bertram Pitt and Javed Butler},
journal = {Kidney360},
year = {2026},
month = oct,
doi = {10.34067/kid.0000001272},
url = {https://hal.univ-lorraine.fr/hal-05850584v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Patiromer Efficacy across Kidney Function and Hyperkalemia Subgroups in Heart Failure and Reduced Ejection Fraction
AU - Andreas P Kalogeropoulos
AU - Ahmed Mustafa Rashid
AU - Stefan D Anker
AU - Antoni Bayes-Genis
AU - Michael Böhm
AU - Jeffrey Budden
AU - John G F Cleland
AU - Andrew J S Coats
AU - Justin A Ezekowitz
AU - Gerasimos Filippatos
AU - Assen Goudev
AU - Muhammad Shahzeb Khan
AU - Joann Lindenfeld
AU - Lars H Lund
AU - Bela Merkely
AU - Robert J Mentz
AU - Marco Metra
AU - Jude Moutchia
AU - Piotr Ponikowski
AU - Patrick Rossignol
AU - Michele Senni
AU - Sandra Waechter
AU - Matthew R Weir
AU - Bertram Pitt
AU - Javed Butler
PY - 2026
DA - 2026/10/22
JO - Kidney360
DO - 10.34067/kid.0000001272
UR - https://hal.univ-lorraine.fr/hal-05850584v1
AB - L L mL/min/1.73m2 and hyperkalemia (-0.28 mEq/L, 95% CI -0.38 to -0.18, P<0.001) and the smallest in those with eGFR ≥45 mL/min/1.73m2 and normokalemia (-0.08 mEq/L, 95% CI -0.12 to -0.04, P<0.001; Pinteraction <0.001). Patiromer reduced time-to-first hyperkalemia consistently across subgroups. Patients with eGFR <45 mL/min/1.73m2 and baseline hyperkalemia derived the numerically greatest effect in prevention of mineralocorticoid receptor antagonist down-titration (hazard ratio 0.39, 95% CI 0.18-0.84, P=0.02) and had the highest win ratio for hyperkalemia-related morbidityadjusted outcomes (3.03, 95% CI 1.96-4.70, P<0.001). However, Pinteraction values for these secondary endpoints were not statistically significant. Conclusions: Patiromer reduced serum potassium across baseline kidney function and hyperkalemia subgroups, with greater effect in patients with reduced kidney function and baseline hyperkalemia. These findings suggest potential heterogeneity in potassium-lowering effects of patiromer across subgroups, although the analysis is exploratory and should be considered hypothesis-generating.
SN - 2641-7650
SN - 2641-7650
ER -