[Current status of persistent chronic hyperkalaemia in France: An expert consensus based on a Delphi approach]

Abstract

Introduction: In France, no consensus document on the management of persistent hyperkalaemia is currently available. Variability in clinical practices has been observed.

Methods: A consensus statement on the definition and the management of persistent hyperkalaemia was developed by a Delphi panel of French nephrologists between December 2019 (26 voting participants among 40 invited panellists in first round) and June 2020 (20 voting participants among 26 panellists in second round).

Results: Persisting hyperkalaemia not controlled with current treatment strategies may be defined as the occurrence of two or more hyperkalaemia episodes within a year despite the administration of cation-exchange resins or loop diuretics during the same year. Some patient characteristics (diabetes, chronic kidney disease from stage 3B to stage 5 without dialysis, chronic heart failure) are associated with an increased risk of developing persistent hyperkalaemia. There is a medical need for the management of persistent hyperkalaemia in patients treated with renin-angiotensin-aldosterone system inhibitors that is not met by current treatment strategies (including available cation-exchange resins).

Conclusions: The panel expressed a need for new treatment strategies validated by clinical trials.

Keywords: Chélateurs du potassium; Consensus Delphi; Delphi consensus; Hyperkalaemia; Hyperkaliémie; Inhibiteurs du système rénine-angiotensine-aldostérone; Insuffisance rénale; Kidney disease; Potassium binders; Renin-angiotensin-aldosterone system inhibitors.