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Potassium Binder Strategy — ESENeph MCQ

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ModerateChronic Kidney DiseasePotassium Binder StrategyESENeph

A 62-year-old man with type 2 diabetes and CKD G3bA3 is on Ramipril, Dapagliflozin, and Finerenone. His potassium has been 5.5-5.8 mmol/L on two occasions. He has no ECG changes. What does KDIGO 2024 recommend regarding the potassium binder approach?

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Correct answer: E — Potassium binders should be used to enable continuation of guideline-directed medical therapy

KDIGO 2024 CKD guideline emphasises that newer potassium binders (Patiromer, Sodium Zirconium Cyclosilicate) can be used to manage hyperkalaemia while enabling continuation of renoprotective therapies (RASi, SGLT2i, nsMRA). Retrospective studies show increased mortality and CV events when RASi is discontinued for hyperkalaemia. The binder approach allows all four pillars of CKD therapy to continue.

Reference: KDIGO 2024 – CKD Guideline