Hyperkalemia in chronic kidney disease: a focus on potassium lowering pharmacotherapy.

Major clinical trials have tested new and promising kidney protective therapies such as sodium/glucose-cotransporter-2 inhibitors and mineralocorticoid-receptor-antagonists, with promising results. Until recently, the only treatment option for hyperkalemia was the cation-exchanging resin sodium-polystyrene-sulfonate. However, despite its common use, the efficacy and safety data of this drug in the long-term management of hyperkalemia are scarce. During the last decade, two novel orally administered K-exchanging compounds (patiromer and sodium-zirconium- cyclosilicate) have been approved the treatment of adults with hyperkalemia, as they both effectively reduce elevated serum K and maintain chronically K balance within the normal range with an excellent tolerability and no serious adverse events.