Medical Costs in Patients with Hyperkalemia on Long-Term Sodium Zirconium Cyclosilicate Therapy: The RECOGNIZE II Study

Figures & data

Figure 1 Diagram of patient flow in the RECOGNIZE II study, before matching.

Note: Boxes with dashed lines represent excluded patients.

Abbreviations: HK, hyperkalemia; SZC, sodium zirconium cyclosilicate.

Table 1 Patient Demographics, Comorbidities, Baseline Treatments, and Healthcare Resource Utilization After 1:1 Matching

	Non-SZC Matched N=661	SZC Matched N=661	Propensity Score SMD
Age, years, mean ± SD	60.8 ± 13.2	60.0 ± 13.3	0.06
Sex, n (%)
Female	236 (35.7)	219 (33.1)	0.06
Male	425 (64.3)	442 (66.9)
Payer, n (%)
Commercial	478 (72.3)	512 (77.5)	0.12
Medicare Advantage	183 (27.7)	149 (22.5)
US Census region, n (%)
Midwest	190 (28.7)	189 (28.6)	0.08
Northeast	82 (12.4)	81 (12.3)
South	294 (44.5)	276 (41.8)
West	95 (14.4)	115 (17.4)
CCI score, mean ± SD	2.9 ± 2.2	2.6 ± 1.8	0.17
Comorbidity (diagnosis history), n (%)
Hypertension	603 (91.2)	580 (87.7)	0.11
Type 2 diabetes	429 (64.9)	399 (60.4)	0.09
CKD	409 (61.9)	409 (61.9)	0.00
Dyslipidemia	407 (61.6)	392 (59.3)	0.05
ESKD	177 (26.8)	177 (26.8)	0.00
Coronary artery disease	167 (25.3)	150 (22.7)	0.06
Heart failure	150 (22.7)	119 (18.0)	0.12
Arrhythmia	54 (8.2)	52 (7.9)	0.01
Recurrent HK	413 (62.5)	413 (62.5)	0.00
New-onset HK	248 (37.5)	248 (37.5)	0.00
Baseline treatments, n (%)
Oral anti-HK medications	160 (24.2)	174 (26.3)	0.05
Dialysis	147 (22.2)	132 (20.0)	0.06
RAASi	363 (54.9)	378 (57.2)	0.05
CV medications^a	616 (93.2)	612 (92.6)	0.02
Glucose-lowering medications^b	327 (49.5)	309 (46.7)	0.06
Healthcare resource utilization, n (%)
Inpatient admission	156 (23.6)	156 (23.6)	0.00
ED visit	178 (26.9)	159 (24.1)	0.07
Medical costs, mean ± SD, US$
All-cause	21,106.47 ± 34,219.72	20,378.04 ± 33,815.41	0.02
HK-related	6900.67 ± 20,604.42	4658.51 ± 14,063.85	0.16

Notes: ^aIncluding alpha-blockers, beta-blockers, calcium channel blockers, anticoagulants, antiplatelets, lipid-lowering drugs, loop diuretics, and thiazide diuretics. ^bIncluding metformin, sulfonylureas, dipeptidylpeptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, sodium–glucose cotransporter-2 inhibitors, insulin, and thiazolidinediones.

Abbreviations: CCI, Charlson Comorbidity Index; CKD, chronic kidney disease; CV, cardiovascular; ED, emergency department; ESKD, end-stage kidney disease; HK, hyperkalemia; RAASi, renin–angiotensin–aldosterone system inhibitor; SD, standard deviation; SMD, standardized mean difference; SZC, sodium zirconium cyclosilicate; US, United States.

Figure 2 Mean hyperkalemia-related medical costs over 6 months’ follow-up for patients receiving long-term SZC treatment (SZC cohort) compared with those of matched patients with hyperkalemia not on SZC (non-SZC cohort).

Notes: *P<0.001 versus non-SZC cohort. Costs were adjusted for inflation to 2021 US dollars.

Abbreviations: ED, emergency department; SZC, sodium zirconium cyclosilicate.

Figure 3 Mean all-cause medical costs over 6 months’ follow-up for patients receiving long-term SZC treatment (SZC cohort) compared with those of matched patients with hyperkalemia not on SZC (non-SZC cohort).

Notes: *P<0.01 versus non-SZC cohort; **P<0.001 versus non-SZC cohort. Costs were adjusted for inflation to 2021 US dollars.

Abbreviations: ED, emergency department; SZC, sodium zirconium cyclosilicate.