On 2015 Jan 05, NephJC - Nephrology Journal Club commented:

This study was discussed on Dec 2nd 2014 in the open online nephrology journal club, #NephJC, on twitter (along with a related article).

Introductory comments, written by Eoin O'Sullivan, are available at the NephJC website and cross-posted at the Renal Fellow Network blog.

The discussion was quite intense, with more than 50 participants, including nephrologists, emergency medicine physicians, fellows and residents as also two of the authors, Bhupinder Singh and Edgar Lerma.

A transcript and a curated (i.e. Storified) version of the tweetchat are available from the NephJC website.

The highlights of the tweetchat were:

• There is considerable interest in a drug such as ZS-9, given the incidence of hyperkalemia, both acute and chronic, sometimes resulting in the need to stop ACE-inhibitors and ARBs in CKD patients.

• There was considerable discussion about the choice of placebo (as against sodium polystyrene sultanate, or diuretics and/or low potassium diet) as a comparator; the authors provided insight that this was mainly to comply with FDA requirements.

• Though the results of the trial show that ZS-9 as studied was effective in lowering potassium levels, more information about the differential incidence of edema as also the details of diuretic use in both groups was sought.

Overall, though there is considerable enthusiasm about the availability of new agents for management of hyperkalemia, considerations of safety, cost and data from more studies will determine how widely this drug will be used once licensed.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at NephJC.com.

On 2015 Jan 05, NephJC - Nephrology Journal Club commented:

This study was discussed on Dec 2nd 2014 in the open online nephrology journal club, #NephJC, on twitter (along with a related article).

Introductory comments, written by Eoin O'Sullivan, are available at the NephJC website and cross-posted at the Renal Fellow Network blog.

The discussion was quite intense, with more than 50 participants, including nephrologists, emergency medicine physicians, fellows and residents as also two of the authors, Bhupinder Singh and Edgar Lerma.

A transcript and a curated (i.e. Storified) version of the tweetchat are available from the NephJC website.

The highlights of the tweetchat were:

• There is considerable interest in a drug such as ZS-9, given the incidence of hyperkalemia, both acute and chronic, sometimes resulting in the need to stop ACE-inhibitors and ARBs in CKD patients.

• There was considerable discussion about the choice of placebo (as against sodium polystyrene sultanate, or diuretics and/or low potassium diet) as a comparator; the authors provided insight that this was mainly to comply with FDA requirements.

• Though the results of the trial show that ZS-9 as studied was effective in lowering potassium levels, more information about the differential incidence of edema as also the details of diuretic use in both groups was sought.

Overall, though there is considerable enthusiasm about the availability of new agents for management of hyperkalemia, considerations of safety, cost and data from more studies will determine how widely this drug will be used once licensed.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at NephJC.com.