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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Nephrology

Advisor

Victoria Beloy DMSc, PA-C

Abstract

ABSTRACT

Hyperkalemia complicates chronic kidney disease (CKD) management. Declining kidney function leads to potassium accumulation. Renin-angiotensin-aldosterone system inhibitors (RAASi) are first-line therapies for CKD. These agents, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, can further increase serum potassium levels. This review examines strategies to manage chronic hyperkalemia with potassium binders, patiromer and sodium zirconium cyclosilicate, as well as evolving dietary approaches. Effective potassium control may enable maximally tolerated RAASi dosing. Emerging evidence suggests that dietary management of hyperkalemia is shifting from blanket recommendations for a low-potassium diet to limiting low-nutrient, additive potassium sources. Together, these strategies promote an individualized, evidence-based approach to controlling hyperkalemia and optimizing RAASi prescribing to maximize cardiorenal protection.

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