Non-steroidal mineralocorticoid antagonists and hyperkalemia monitoring in chronic kidney disease patients associated with type II diabetes: a narrative review

References

• Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine [Internet]. 2022 Aug 27;38(11):602–606. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1357303922001839
   Google Scholar
• Center for Disease Control and Prevention. National diabetes statistics report [Internet]. CDC; 2022. Available from: https://www.cdc.gov/diabetes/data/statistics-report/index.html
   Google Scholar
• Centers. National Diabetes Statistics Report, 2017- estimates of diabetes and its burden in the United States background [internet]. Allegheny County (PA): Policycommons.Net.; 2017 [cited 2023 Jun 24]. Available from: https://policycommons.net/artifacts/3490914/national-diabetes-statistics-report-2017/4291734/
   Google Scholar
• Muntner P, Newsome B, Kramer H, et al. Racial differences in the incidence of chronic kidney disease. Clin J Am Soc Nephrol [Internet]. 2012 Jan 1;7(1):101–107. doi: 10.2215/CJN.06450611
   PubMed Web of Science ®Google Scholar
• Briasoulis A, Bakris GL. Chronic kidney disease as a coronary artery disease risk equivalent. Curr Cardiol Rep. 2013 Jan 22;15(3). doi: 10.1007/s11886-012-0340-4
   PubMed Web of Science ®Google Scholar
• Rossing P, Caramori ML, Chan JCN, et al. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2022 Nov;102(5):S1–127.
   PubMed Web of Science ®Google Scholar
• Collins AJ, Pitt B, Reaven N, et al. Association of serum potassium with all-cause mortality in patients with and without heart failure, chronic kidney disease, and/or diabetes. Am J Nephrol. 2017;46(3):213–221. doi: 10.1159/000479802
   PubMed Web of Science ®Google Scholar
• Brown WW, Peters RM, Ohmit SE. et al. Early detection of kidney disease in community settings: the kidney early evaluation program (KEEP). Am J Kidney Diseases. 2003 Jul;42(1):22–35.
   PubMed Web of Science ®Google Scholar
• Vassalotti JA, Li S, Chen SC. et al. Screening populations at increased risk of CKD: the kidney early evaluation program (KEEP) and the public health problem. Am J Kidney Diseases [Internet]. 2009 Mar;53(3):S107–14. [cited 2019 Dec 10]. Available from: https://www.ajkd.org/article/S0272-6386(08)01723-X/fulltext
   PubMed Web of Science ®Google Scholar
• Saunders MR, Cifu A, Vela M. Screening for chronic kidney disease. JAMA. 2015 Aug 11;314(6):615. doi: 10.1001/jama.2015.9425
   PubMed Web of Science ®Google Scholar
• National Kidney Foundation. Fact Sheets [Internet]. National Kidney Foundation; 2014. Available from: https://www.kidney.org/news/newsroom/fsindex
   Google Scholar
• Folkerts K, Petruski-Ivleva N, Comerford E, et al. Adherence to chronic kidney disease screening guidelines among patients with type 2 diabetes in a US administrative claims database. Mayo Clin Proc [Internet]. 2021 Apr 1 [cited 2021 Dec 1];96(4):975–986. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30933-2/fulltext#relatedArticles
   PubMed Web of Science ®Google Scholar
• Shlipak MG, Tummalapalli SL, Boulware LE, et al. The case for early identification and intervention of chronic kidney disease: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference. Kidney Int. 2021 Jan 1;99(1):34–47.
   PubMed Web of Science ®Google Scholar
• Webster AC, Nagler EV, Morton RL .et al. Chronic kidney disease. Lancet [Internet] 2017 Mar;389(10075):1238–1252. Available from: https://pubmed.ncbi.nlm.nih.gov/27887750/
   PubMed Web of Science ®Google Scholar
• Heyman SN, Raz I, Dwyer JP, et al. Diabetic proteinuria revisited: updated physiologic perspectives. Cells. 2022 Sep 18;11(18):2917. doi: 10.3390/cells11182917
   PubMed Web of Science ®Google Scholar
• Palmer BF, Clegg DJ. Extrarenal Effects of Aldosterone on Potassium Homeostasis. Kidney360. 2022 Jan 14;3(3). doi: 10.34067/KID.0006762021
   PubMedGoogle Scholar
• Palmer BF. Regulation of Potassium Homeostasis. Clin J Am Soc Nephrol [Internet] [2014 Apr 10];10(6):1050–1060. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455213/
   PubMed Web of Science ®Google Scholar
• Hunter RW, Bailey MA. Hyperkalemia: pathophysiology, risk factors and consequences. Nephrol Dialysis Transplantation. 2019 Dec 1;34(Supplement_3):iii2–11. doi: 10.1093/ndt/gfz206
   PubMedGoogle Scholar
• Heitzmann D, Warth R. Physiology and pathophysiology of potassium channels in gastrointestinal epithelia. Physiol Rev. 2008 Jul;88(3):1119–1182. doi: 10.1152/physrev.00020.2007
   PubMed Web of Science ®Google Scholar
• Sousa AGP, de Sde S CJ, El-Feghaly WB, et al. Hyporeninemic hypoaldosteronism and diabetes mellitus: pathophysiology assumptions, clinical aspects and implications for management. World J Diabetes [Internet]. 2016 Mar 10 [cited 2021 Apr 4];7(5):101–111. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781902/
   PubMedGoogle Scholar
• St-Jules DE, Clegg DJ, Palmer BF, et al. Can novel potassium binders liberate people with chronic kidney disease from the low-potassium diet? Clin J Am Soc Nephrol. 2021 Oct 20;17(3):467–472. doi: 10.2215/CJN.09660721
   PubMed Web of Science ®Google Scholar
• Clive DM, Clive PH. Chapter 65 - Nonsteroidal Antiinflammatory Drugs and Opioids in Chronic Kidney Disease [Internet]. In: Kimmel PL, Rosenberg ME, editors. ScienceDirect. Academic Press; 2020 [2024 Dec 23]. p.1071–1092. Availble from: .https://www.sciencedirect.com/science/article/abs/pii/B9780128158760000656
   Google Scholar
• Gómez-Huelgas R, Sanz-Cánovas J, Cobos-Palacios L. et al. Glucagon-like peptide-1 receptor agonists and sodium−glucose cotransporter 2 inhibitors for cardiovascular and renal protection: a treatment approach far beyond their glucose-lowering effect. Eur J Internal Med. 2022 Feb 1;96:26–33. doi: 10.1016/j.ejim.2021.11.008
   PubMed Web of Science ®Google Scholar
• Brown E, Heerspink HJL, Cuthbertson DJ. et al. SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications. Lancet. 2021 Jul;398(10296):262–276.
   PubMed Web of Science ®Google Scholar
• Yin W, Xu S, Wang Z. et al. Recombinant human GLP-1(rhGLP-1) alleviating renal tubulointestitial injury in diabetic STZ-induced rats. Biochem Biophys Res Commun. 2018 Jan 1;495(1):793–800. doi: 10.1016/j.bbrc.2017.11.076
   PubMed Web of Science ®Google Scholar
• Hendarto H, Inoguchi T, Maeda Y. et al. GLP-1 analog liraglutide protects against oxidative stress and albuminuria in streptozotocin-induced diabetic rats via protein kinase A-mediated inhibition of renal NAD(P)H oxidases. Metabolism. 2012 Oct;61(10):1422–1434.
   PubMed Web of Science ®Google Scholar
• Mann JFE, Ørsted DD, Brown-Frandsen K. et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med. 2017 Aug 31;377(9):839–848. doi: 10.1056/NEJMoa1616011
   PubMed Web of Science ®Google Scholar
• Botros FT, Gerstein HC, Malik R. et al. Dulaglutide and kidney function–related outcomes in type 2 diabetes: a REWIND post Hoc analysis. Diabetes Care. 2023 Jun 21;46(8):1524–1530. doi: 10.2337/dc23-0231
   PubMed Web of Science ®Google Scholar
• Kristensen SL, Rørth R, Jhund PS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol [Internet]. 2019 Aug;7(10):776–785. [cited 2019 Sep 11]. Available from: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30249-9/fulltext
   PubMed Web of Science ®Google Scholar
• Rossing P, Baeres FMM, Bakris G. et al. The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease. Nephrol Dialysis Transplantation. 2023 Jan 18;38(9):2041–2051. doi: 10.1093/ndt/gfad009
   PubMed Web of Science ®Google Scholar
• Philippidis A. StockWatch: novo nordisk shares soar as ozempic aces phase III CKD trial. GEN Edge. 2023 Jan 1;5(1):708–713. doi: 10.1089/genedge.5.1.137
   Google Scholar
• Heerspink HJL, Stefánsson BV, Correa-Rotter R. et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med [Internet] 2020 Sep 24;383(15):1436–1446. doi: 10.1056/NEJMoa2024816
   PubMed Web of Science ®Google Scholar
• Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med [Internet]. 2019 Jun 13[cited 2019 Jun 13];380(24): 2295–2306. doi: 10.1056/NEJMoa1811744
   PubMed Web of Science ®Google Scholar
• The EMPA-KIDNEY Collaborative Group. Empagliflozin in patients with chronic kidney disease. N Engl J Med. 2022 Nov 4; 388(2):117–127.
   PubMed Web of Science ®Google Scholar
• Kaze AD, Zhuo M, Kim SC, et al. Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis. Cardiovasc Diabetol. 2022 Mar 23;21(1). doi: 10.1186/s12933-022-01476-x
   Web of Science ®Google Scholar
• Mavrakanas TA, Tsoukas MA, Brophy JM, et al. SGLT-2 inhibitors improve cardiovascular and renal outcomes in patients with CKD: a systematic review and meta-analysis. Sci Rep [Internet]. 2023 Sep 23 [cited 2023 Nov 12];13(1):15922. Available from: https://www.nature.com/articles/s41598-023-42989-z#:~:text=Use%20of%20an%20SGLT%2D
   PubMed Web of Science ®Google Scholar
• Lo K, Gul F, Ram P, et al. The effects of SGLT2 inhibitors on cardiovascular and renal outcomes in diabetic patients: a systematic review and meta-analysis. Cardiorenal Med. 2019 Nov 19;10(1):1–10. doi: 10.1159/000503919
   PubMed Web of Science ®Google Scholar
• Bae JH, Park EG, Kim S. et al. Effects of sodium-glucose cotransporter 2 inhibitors on renal outcomes in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2019 Sep 10;9(1). doi: 10.1038/s41598-019-49525-y
   Google Scholar
• IH DB, Khunti K, Sadusky T, et al. Diabetes management in chronic kidney disease: a consensus report by the American diabetes Association (ADA) and kidney disease: improving global outcomes (KDIGO). Diabetes Care. 2022 Oct 3;45(12):3075–3090. doi: 10.2337/dci22-0027
   PubMed Web of Science ®Google Scholar
• ElSayed NA, Aleppo G, Aroda VR, et al. American Diabetes Association. 11. Chronic kidney disease and risk management: standards of care in Diabetes—2023. Diabetes Care. 2023;46(Suppl. 1):S191–S202. doi: 10.2337/dc23-S011
   PubMedGoogle Scholar
• Giaccari A, Pontremoli R, Perrone Filardi P. SGLT-2 inhibitors for treatment of heart failure in patients with and without type 2 diabetes: a practical approach for routine clinical practice. Int J Cardiol. 2022 Mar;351:66–70. doi: 10.1016/j.ijcard.2021.12.050
   PubMed Web of Science ®Google Scholar
• Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med [Internet]. 1999 Sep 2;341(10):709–717. doi: 10.1056/NEJM199909023411001
   PubMed Web of Science ®Google Scholar
• Pitt B, Remme W, Zannad F. et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003 Apr 3;348(14):1309–1321. doi: 10.1056/NEJMoa030207
   PubMed Web of Science ®Google Scholar
• Pfeffer MA, Claggett B, Assmann SF, et al. Regional variation in patients and outcomes in the treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT) trial. Circulation [Internet]. 2015 Jan 6 [cited 2021 Jan 28];131(1):34–42. Available from: https://pubmed.ncbi.nlm.nih.gov/25406305/
   PubMed Web of Science ®Google Scholar
• Butler J, Vijayakumar S, Pitt B. Need to revisit heart failure treatment guidelines for hyperkalaemia management during the use of mineralocorticoid receptor antagonists. Eur J Heart Fail. 2018 Jun 8;20(9):1247–1251. doi: 10.1002/ejhf.1217
   PubMed Web of Science ®Google Scholar
• Agarwal R, Rossignol P, Romero A. et al. Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial. Lancet. 2019 Sep;394(10208):1540–1550.
   PubMed Web of Science ®Google Scholar
• Lainscak M, Pelliccia F, Rosano G. et al. Safety profile of mineralocorticoid receptor antagonists: spironolactone and eplerenone. Int J Cardiol [Internet]. 2015 [cited 2020 Jan 27];200:25–29. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26404748
   PubMed Web of Science ®Google Scholar
• Vukadinović D, Lavall D, Vukadinović AN. et al. True rate of mineralocorticoid receptor antagonists-related hyperkalemia in placebo-controlled trials: a meta-analysis. Am Heart J. 2017 Jun;188:99–108.
   PubMed Web of Science ®Google Scholar
• Agarwal R, Kolkhof P, Bakris G, et al. Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine. Eur Heart J. 2020 Oct 25;42(2):152–161. doi: 10.1093/eurheartj/ehaa736
   Web of Science ®Google Scholar
• Kolkhof P, Jaisser F, Kim SY. Steroidal and Novel Non-steroidal Mineralocorticoid Receptor Antagonists in Heart Failure and Cardiorenal Diseases: Comparison at Bench and Bedside. In: Bauersachs J, Butler J, Sandner P, editors. Heart Failure. Handbook of Experimental Pharmacology. Vol. 243. Cham: Springer; 2016. p. 271–305. doi: 10.1007/164_2016_76
   Google Scholar
• Parving HH, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012 Dec 6;367(23):2204–2213. doi: 10.1056/NEJMoa1208799
   PubMed Web of Science ®Google Scholar
• Fried LF, Emanuele N, Zhang JH. et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med. 2013 Nov 14;369(20):1892–1903. doi: 10.1056/NEJMoa1303154
   PubMed Web of Science ®Google Scholar
• Bakris GL, Agarwal R, Anker SD, et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med [Internet]. 2020 Dec 3;383(23):2219–2229. doi: 10.1056/NEJMoa2025845
   PubMed Web of Science ®Google Scholar
• Filippatos G, Pitt B, Agarwal R, et al. Finerenone in patients with chronic kidney disease and type 2 diabetes with and without heart failure: a prespecified subgroup analysis of the FIDELIO‐DKD trial. Eur J Heart Fail. 2022 May 19;24(6):996–1005. doi: 10.1002/ejhf.2469
   PubMed Web of Science ®Google Scholar
• Agarwal R, Filippatos G, Pitt B, et al. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2021 Nov 22;43(6):474–484. doi: 10.1093/eurheartj/ehab777
   Web of Science ®Google Scholar
• Wanner C, Fioretto P, Kövesdy CP. et al. Potassium management with finerenone: practical aspects. Endocrinol Diabetes Metabol. 2022 Sep 15;5(6). doi: 10.1002/edm2.360
   PubMedGoogle Scholar
• Haynes R, Mason PD, Rahimi K, et al. Dual blockade of the renin-angiotensin system: are two better than one? Nephrol Dialysis Transplantation. 2009 Sep 17;24(12):3602–3607. doi: 10.1093/ndt/gfp458
   PubMed Web of Science ®Google Scholar
• Kolkhof P, Hartmann E, Freyberger A, et al. Effects of finerenone combined with Empagliflozin in a model of hypertension-Induced end-organ damage. Am J Nephrol [Internet]. 2021 Jun 10 [cited 2023 May 14];52(8):642–652. Available from: https://karger.com/ajn/article/52/8/642/827352/Effects-of-Finerenone-Combined-with-Empagliflozin
   PubMed Web of Science ®Google Scholar
• Agarwal R, Rifkin B. Moderating effects in randomized trials—interpreting the P value, confidence intervals, and hazard ratios. Kidney Int Rep. 2022 Mar;7(3):371–374. doi: 10.1016/j.ekir.2022.01.1049
   PubMed Web of Science ®Google Scholar
• Green JC, Mottl AK, Bakris GL, et al. Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using a UACR endpoint study (CONFIDENCE). Nephrol Dialysis Transplantation. 2022 Jun 14;38(4):894–903. doi: 10.1093/ndt/gfac198
   Web of Science ®Google Scholar
• Nikolaou NI, Arntz HR, Bellou A, et al. European resuscitation council guidelines for resuscitation 2015 section 8. Initial management of acute coronary syndromes. Resuscitation. 2015 Oct;95:264–277.
   PubMed Web of Science ®Google Scholar
• Howlett JG, Chan M, Ezekowitz JA. et al. The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your Practice. Can J Cardiol. 2016 Mar;32(3):296–310.
   PubMed Web of Science ®Google Scholar
• Alfonzo A, Harrison A, Chu A, et al. Clinical practice guidelines treatment of acute hyperkalaemia in adults mr Simon Mann renal pharmacist, Lancashire Teach Hosp NHS Found Trust [Internet]. 2020 Jun. Available from: https://ukkidney.org/sites/renal.org/files/RENAL%20ASSclaseOCIATION%20HYPERKALAEMIA%20GUIDELINE%20-%20JULY%202022%20V2_0.pdf
   Google Scholar
• Clase CM, Carrero JJ, Ellison DH, et al. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference. Kidney Int. 2020 Jan;97(1):42–61.
   PubMed Web of Science ®Google Scholar
• Goulooze SC, Snelder N, Seelmann A, et al. Finerenone dose–exposure–serum potassium response analysis of FIDELIO-DKD phase III: the role of dosing, titration, and inclusion criteria. Clin Pharmacokinet. 2021 Nov 17;61(3):451–462. doi: 10.1007/s40262-021-01083-1
   PubMed Web of Science ®Google Scholar
• Palmer BF, Clegg DJ. Physiology and pathophysiology of potassium homeostasis. Adv Physiol Educ. 2016 Dec;40(4):480–490. doi: 10.1152/advan.00121.2016
   PubMed Web of Science ®Google Scholar
• Sarnowski A, Gama RM, Dawson A, et al. Hyperkalemia in Chronic Kidney Disease: Links, Risks and Management. Int J Nephrol Renovasc Dis. 2022 Aug;15:215–228. doi: 10.2147/IJNRD.S326464
   PubMed Web of Science ®Google Scholar
• Long B, Warix JR, Koyfman A. Controversies in Management of Hyperkalemia. J Emergency Med [Internet] 2018 Aug;55(2):192–205. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0736467918303421
   PubMed Web of Science ®Google Scholar
• Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017;12(12):2032–2045. doi: 10.2215/CJN.11491116
   PubMed Web of Science ®Google Scholar
• Putcha N, Allon M. Management of Hyperkalemia in Dialysis Patients. Semin Dial [Internet]. 2007 Jun 30;20(5):431–439. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1525-139X.2007.00312
   PubMed Web of Science ®Google Scholar
• Arthur G. Diuretic Complications. Am J Med Sci [Internet]. 2000 Jan 1;319(1):10–24. Available from https://www.sciencedirect.com/science/article/abs/pii/S0002962915406767
   PubMed Web of Science ®Google Scholar
• Kim MJ, Valerio C, Knobloch GK. Potassium disorders: hypokalemia and hyperkalemia. Am Fam Physician [Internet]. 2023 Jan 1;107(1):59–70A. Available from: https://www.aafp.org/pubs/afp/issues/2023/0100/potassium-disorders-hypokalemia-hyperkalemia.html
   PubMed Web of Science ®Google Scholar
• Luo J, Brunelli SM, Jensen DE, et al. Association between serum potassium and outcomes in patients with reduced kidney function. Clin J Am Soc Nephrol. 2015 Oct 23;11(1):90–100. doi: 10.2215/CJN.01730215
   PubMed Web of Science ®Google Scholar
• Furuland H, McEwan P, Evans M, et al. Serum potassium as a predictor of adverse clinical outcomes in patients with chronic kidney disease: new risk equations using the UK clinical practice research datalink. BMC Nephrol. 2018 Aug 22;19(1). doi: 10.1186/s12882-018-1007-1
   Google Scholar
• Epstein M, Nancy M, Ens Funk S, et al. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. PubMed. 2015 Sep 1;21(11 Suppl):S212–20
   Google Scholar
• Kanda E, Jr CP, Rastogi A, et al.#3303 Suboptimal extent of raasi re-initiation after discontinuation following hyperkalemia: an observational study of cardiorenal patients in the US and Japan.2023 Jun 1;38Supplement_1. doi: 10.1093/ndt/gfad063c_3303
   Google Scholar
• Overview | Sodium zirconium cyclosilicate for treating hyperkalaemia | Guidance | NICE [Internet]. Available from: https://www.nice.org.uk/guidance/ta599
   Google Scholar
• Rosano GMC, Tamargo J, Kjeldsen KP, et al. Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J Cardiovasc Pharmacother. 2018 May 3;4(3):180–188. doi: 10.1093/ehjcvp/pvy015
   PubMed Web of Science ®Google Scholar
• Betts KA, Woolley JM, Mu F, et al. The prevalence of hyperkalemia in the United States. Curr Med Res Opin [Internet]. 2018 Jun 1;34(6):971–978. Available from: https://pubmed.ncbi.nlm.nih.gov/29368958/
   PubMed Web of Science ®Google Scholar
• Khanagavi J, Gupta T, Aronow WS, et al. Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes. Arch Med Sci [Internet]. 2014 May 12 [cited 2020 Sep 2];10(2):251–257. Available from https://pubmed.ncbi.nlm.nih.gov/24904657/
   PubMed Web of Science ®Google Scholar
• Eliacik E, Yildirim T, Sahin U.et al.Potassium abnormalities in Current clinical practice: frequency, causes, severity and management.Med Princ Pract [Internet]. 2015 Mar 11 [cited 2021 Mar 15];243:271–275. Available from: https://www.karger.com/Article/Pdf/376580
   PubMed Web of Science ®Google Scholar
• Desai NR, Reed PJ, Alvarez PJ, et al. The economic implications of hyperkalemia in a Medicaid managed care population. PubMed. 2019 Nov 1;12(7):352–361
   Google Scholar
• Ramakrishnan C, Tan NC, Yoon S. et al. Healthcare professionals’ perspectives on facilitators of and barriers to CKD management in primary care: a qualitative study in Singapore clinics. BMC Health Serv Res. 2022 Apr 26;22(1). doi: 10.1186/s12913-022-07949-9
   PubMed Web of Science ®Google Scholar
• Pang J, Grill A, Bhatt M, et al. Evaluation of a mentorship program to support chronic kidney disease care. PubMed. 2016 Aug 1;62(8):e441–7
   Google Scholar
• Chiu M, Garg AX, Moist L, et al. A new perspective to longstanding challenges with outpatient hyperkalemia: a narrative review. Can J Kidney Health Dis. 2023 Jan;10:205435812211497. doi: 10.1177/20543581221149710
   Google Scholar