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This website is intended for UK Healthcare Professionals only. Other UK residents please visit astrazeneca.co.uk
LOKELMA® (sodium zirconium cyclosilicate) is indicated for the treatment of hyperkalaemia in adult patients.
Test how different treatment approaches can have different outcomes for your patients.
>2x higher mortality rates were observed with submaximal doses or discontinuation versus a maximal dose of RAASi.2
Adapted from Epstein et al. (2015)2
Retrospective analysis of a US database of electronic health records (Humedica; N>200,000) of patients ≥5 years of age with various comorbidities, with ≥2 serum potassium readings, with ≥1 out-patient RAASi prescription from 2007 to 2012 and who were receiving maximum doses of RAASi therapy.2 Inclusion criteria required 12 months of data prior to index date.2 RAASi includes ACEi, ARB, direct renin inhibitor and select MRA.2
Down-titrating RAASi therapy results in a risk of progressoin to ESKD similar to discontinuing RAASi entirely
increased risk with RAASi
discontinuation
(n=138/2460)
compared to the risk with RAASi
maintenanceb (n=138/4586)
increased risk with RAASi
down-titration
(n=23/460)
compared to the risk with RAASi
maintenanceb (n=138/4586)
"Initiation of hemodialysis or a diagnosis of ESKD or CKD Stage 5 in any position recorded in hospital, emergency, or outpatient setting:3 bp<0.05 for each comparison and adjusted for age, sex, history of hyperkalaemia, T2 diabetes, HF, CKD including stage, and baseline use of ACEi, ARB, ARNi, and MRA;3
Note: An observational study that utilised the US claims and EHR data from July 2019 and September 2021 in 15,488 adult patients with CKD Stage 3 or 4 and/or HF who experienced an index HK event (ICD-10 or ICD-9 diagnosis codes) and had ≥1 filled RAASi prescription within 6 months before the index HK event,3 RAASi included ACEi, ARB. ARNi, and MRA.3,4 Subgroups of patients with CKD (n=11,873; identified using diagnosis codes or eGFR) and patients with HF (n=9086: identified using diagnosis codes) were also evaluated after index HK event.3
Down-titrating RAASi results in a mortality risk similar to discontinuing RAASi entirely
increased risk with RAASi
discontinuation
(n=392/1966)
compared to the risk with RAASi
maintenanceb (n=421/3049)
increased risk with RAASi
down-titration
(n=84/430)
compared to the risk with RAASi
maintenanceb (n=421/3049)
Note: An observational study that utilised the US claims and EHR data from July 2019 and September 2021 in 15,488 adult patients with CKD Stage 3 or 4 and/or HF who experienced an index HK event (ICD-10 or ICD-9 diagnosis codes) and had ≥1 filled RAASi prescription within 6 months before the index HK event.3
RAASi included ACEI, ARB, ARNi, and MRA.3,4 Subgroups of patients with CKD (n=11,873; identified using diagnosis codes or eGFR) and patients with HF (n=9086; identified using diagnosis codes) were also evaluated after index HK event.3
*p<0.05 for each comparison and adjusted for age, sex, history of hyperkalaemia, Type 2 diabetes, HF, CKD including stages 3 and 4, and baseline use of ACEi, ARB, ARNi, and MRA,3 hospitalisations with HF or emergency visits for HF.3
Following a moderate-to-severe hyperkalaemia event, almost half of patients’ RAASi therapy is either downtitrated or discontinued, as is the case for over a third of patients who have experienced a mild hyperkalaemia event.2
Adapted from Epstein et al. (2015)2
Retrospective analysis of electronic health records (N>200,000) of patients with various comorbidities, with at least 2 serum potassium readings, and on at least 1 RAASi treatment from Humedica (US) in 2007–2012 among patients on maximum doses of RAASi.2 For the remaining events, the data period following a hyperkalaemia event was not sufficient to determine subsequent RAASi dose level.2 RAASi includes ACEis, ARBs, direct renin inhibitors, and select MRAs.2
The UK reported the highest rates of RAASi therapy discontinuation among the European countries analysed4.
An observational study of claims, registries and hospital medical records between January 2018 to December 20224
aA ZORA study in 40,059 adult patients with CKD not on dialysis and/or HF with an index hyperkalaemia episode (ICD-10 diagnosis code in all countries or as recorded K+ >5.0 mmol/L in Spain and Sweden) while on RAASi therapy (ACEi, ARB, ARNi, MRA)4
The patient groups most at risk of hyperkalaemia are those with CKD, diabetes mellitus and HF.3,4 Hyperkalaemia may also occur after initiation or uptitration of RAASi medications to treat these conditions as RAASi medications are drugs that can cause high potassium levels.4
Hyperkalaemia develops in approximately 10% of out-patients within 1 year after initiation of RAASi drugs, thereby limiting treatment in the patients who receive the greatest benefit from this therapy.5
If you have any questions about LOKELMA or would like to speak to an
AstraZeneca representative, please contact us
ACEi=angiotensin-converting enzyme inhibitor; ARB=angiotensin receptor blocker; ARNi=angiotensin receptor-neprilysin inhibitor; CKD=chronic kidney disease; GFR=glomerular filtration rate; HF=heart failure; MRA=mineralocorticoid receptor antagonist; RAASi=renin-angiotensin-aldosterone system inhibitor; CKD=chronic kidney disease; HK=hyperkalaemia; ESKD=end-stage kidney disease; RWE=real-world evidence.
GB-69623 | DOP: November 2025
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This website was created for UK HCPs and has been designed to provide information to educate, empower and enable them in the great work they are doing for patients across a range of therapy areas. This website is intended for doctors, nurses, and pharmacists in the UK. Other UK residents please visit astrazeneca.co.uk.
