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Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone

The nonsteroidal mineralocorticoid receptor (MR) blocker esaxerenone has demonstrated good antihypertensive activity in a variety of patients, including those with uncomplicated grade I–III hypertension, hypertension with moderate renal dysfunction, hypertension with type 2 diabetes mellitus with al...

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Autores principales: Rakugi, Hiromi, Yamakawa, Satoru, Sugimoto, Kotaro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019656/
https://www.ncbi.nlm.nih.gov/pubmed/33214722
http://dx.doi.org/10.1038/s41440-020-00569-y
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author Rakugi, Hiromi
Yamakawa, Satoru
Sugimoto, Kotaro
author_facet Rakugi, Hiromi
Yamakawa, Satoru
Sugimoto, Kotaro
author_sort Rakugi, Hiromi
collection PubMed
description The nonsteroidal mineralocorticoid receptor (MR) blocker esaxerenone has demonstrated good antihypertensive activity in a variety of patients, including those with uncomplicated grade I–III hypertension, hypertension with moderate renal dysfunction, hypertension with type 2 diabetes mellitus with albuminuria, and hypertension associated with primary aldosteronism. Hyperkalemia has long been recognized as a potential side effect occurring during treatment with MR blockers, but there is a lack of understanding and guidance about the appropriate management of hyperkalemia during antihypertensive therapy with MR blockers, especially in regard to the newer agent esaxerenone. In this article, we first highlight risk factors for hyperkalemia, including advanced chronic kidney disease, diabetes mellitus, cardiovascular disease, age, and use of renin-angiotensin-aldosterone system inhibitors. Next, we examine approaches to prevention and management, including potassium monitoring, diet, and the use of appropriate therapeutic techniques. Finally, we summarize the currently available data for esaxerenone and hyperkalemia. Proper management of serum potassium is required to ensure safe clinical use of MR blockers, including awareness of at-risk patient groups, choosing appropriate dosages for therapy initiation and dosage titration, and monitoring of serum potassium during therapy. It is critical that physicians take such factors into consideration to optimize MR blocker therapy in patients with hypertension.
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spelling pubmed-80196562021-04-16 Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone Rakugi, Hiromi Yamakawa, Satoru Sugimoto, Kotaro Hypertens Res Review Article The nonsteroidal mineralocorticoid receptor (MR) blocker esaxerenone has demonstrated good antihypertensive activity in a variety of patients, including those with uncomplicated grade I–III hypertension, hypertension with moderate renal dysfunction, hypertension with type 2 diabetes mellitus with albuminuria, and hypertension associated with primary aldosteronism. Hyperkalemia has long been recognized as a potential side effect occurring during treatment with MR blockers, but there is a lack of understanding and guidance about the appropriate management of hyperkalemia during antihypertensive therapy with MR blockers, especially in regard to the newer agent esaxerenone. In this article, we first highlight risk factors for hyperkalemia, including advanced chronic kidney disease, diabetes mellitus, cardiovascular disease, age, and use of renin-angiotensin-aldosterone system inhibitors. Next, we examine approaches to prevention and management, including potassium monitoring, diet, and the use of appropriate therapeutic techniques. Finally, we summarize the currently available data for esaxerenone and hyperkalemia. Proper management of serum potassium is required to ensure safe clinical use of MR blockers, including awareness of at-risk patient groups, choosing appropriate dosages for therapy initiation and dosage titration, and monitoring of serum potassium during therapy. It is critical that physicians take such factors into consideration to optimize MR blocker therapy in patients with hypertension. Springer Singapore 2020-11-20 2021 /pmc/articles/PMC8019656/ /pubmed/33214722 http://dx.doi.org/10.1038/s41440-020-00569-y Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review Article
Rakugi, Hiromi
Yamakawa, Satoru
Sugimoto, Kotaro
Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title_full Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title_fullStr Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title_full_unstemmed Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title_short Management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
title_sort management of hyperkalemia during treatment with mineralocorticoid receptor blockers: findings from esaxerenone
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019656/
https://www.ncbi.nlm.nih.gov/pubmed/33214722
http://dx.doi.org/10.1038/s41440-020-00569-y
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