Chronic Kidney Disease

The huge burden of potassium imbalance in CKD

Potassium imbalance has long been recognized as a potential “silent killer”, as it can be asymptomatic and can cause abnormal heart rhythms and sudden death¹.

Higher frequency of HyperK in CKD

40-50% of Chronic Kidney Disease (CKD) patients suffer from hyperkalemia compared to 2-3% in the general population²

Higher mortality risks in CKD

2-7 times higher than in the general population³

Immense expenses in CKD

Developed countries spend more than 2–3% of their health care budgets on End Stage Kidney Disease treatment therapy ^4,5

Weiner & Wingo. Hyperkalemia: a potential silent killer. J Am Soc Nephrol 9:1533-1543, 1998
Kovesdy et al. Management of hyperkalaemia in chronic kidney disease. Nat Rev Nephrol. 2014 Sep 16.
Collins AJ 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;46:213-21
WHO, Global burden of kidney disease
Desai et al. The Economic Implications of Hyperkalemia in a Medicaid Managed Care Population. Am Health Drug Benefits. 2019;12(7):352-361
Clase et al. Potassium homeostasis and management of dyskalemia in kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int (2020) 97, 42-61
Epstein et al. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotension-aldosterone system inhibitors. Am J Manag Care. 2015: S212-20

Why is it a challenge to manage potassium in CKD patients?

Secondary effects of life-saving drugs

Dyskalemia occurs frequently in CKD patients as it is a common secondary effect of CKD medical treatment (RAASi, diuretics). While renin-angiotensin-aldosterone system inhibitors (RAASi) drugs are beneficial for these patients, they are also the most prominent cause of hyperkalemia².

Impact of restrictive potassium diet

CKD patients with hyperkalaemia risks are also recommended to have a low potassium diet, meaning low intake of healthy food such as fruits, vegetables… This diet regimen may deprive patients from the beneficial effects of potassium-rich diets, leading to malnutrition and poor quality of life⁶.

What are the consequences?

Drug under-dosed or discontinued

The Life-saving drugs RAASi are generally under-dosed or discontinued by physiscians because of fears for hyperkalemia.

Patients (%)

Patients' mortality (%)

Disease progression

The sub-optimal dose is associated with higher adverse outcomes, including CKD progression and progression to End Stage Renal Disease, and mortality⁷.

Why is Potassium monitoring an immense unmet need ?

What clinicians would like?

.01

Monitoring strategies and measurement methods allowing more frequent potassium testing ⁶.

.02

Strategies that can maintain the use of beneficial medications (i.e. RAASi) while controlling potassium balance ².

.03

Methods that can evaluate the impact of dietary potassium on serum concentration in people with CKD ⁶.

What do patients say about Potassium monitoring?

“A trustable home potassium test, because I have very unstable potassium levels and have to control my potassium at the hospital several times a week”.

“Are there any new developments in the home potassium meters? It gets very frustrating having to wait for blood work to come back in order for the Doctor to give me an IV potassium drip”.

“I am very interested in a home potassium meter/test. Monthly we have to get his blood work done. Having a test for home use would be incredibly helpful to see when he is starting to get high again. Kidney failure patients and heart failure patients definitely have a need for it”.

What if we could change CKD patient’s clinical outcome by improving potassium management ?

By allowing close monitoring of potassium by the patients at home CardioRenal strongly believes that it will help physicians to optimize drug treatment from remote and empower patients to better manage their own health.