Current and future treatment options for managing hyperkalemia

Hyperkalemia is associated with life-threatening cardiac arrhythmias and increased mortality. Hyperkalemia is most often observed in patients with chronic kidney disease and/or in those with congestive heart failure being treated with drugs that limit renal potassium excretion, especially drugs that inhibit the renin-angiotensin-aldosterone system. Treatment of hyperkalemia may be either acute, as needed during rapid changes in serum potassium, which are associated with cardiac arrhythmia, or chronic, which stabilizes serum potassium levels and limits the development of life-threatening arrhythmias. There are a number of both acute and chronic treatments available for the treatment of hyperkalemia, but some are limited by complex administration requirements and/or serious side effects. Hyperkalemia remains a vexing problem for clinicians, particularly in the care of patients with chronic kidney disease and cardiovascular disease.