TY - JOUR
T1 - Potassium Homeostasis in Health and Disease
T2 - A Scientific Workshop Cosponsored by the National Kidney Foundation and the American Society of Hypertension
AU - Kovesdy, Csaba P.
AU - Appel, Lawrence J.
AU - Grams, Morgan E.
AU - Gutekunst, Lisa
AU - McCullough, Peter A.
AU - Palmer, Biff F.
AU - Pitt, Bertram
AU - Sica, Dominic A.
AU - Townsend, Raymond R.
N1 - Funding Information:
We thank the conference participants, who, aside from the authors of this article, included Michael J. Choi, MD, Baltimore, MD; Michel Chonchol, MD, Aurora, CO; Megan Clifford, San Mateo, CA; David H. Ellison, MD, Portland, OR; David Feldman, PhD, New York, NY; Ross D. Feldman, MD, St. John's, Canada; John M. Flack, MD, MPH, Springfield, IL; Allon Friedman, MD, Indianapolis, IN; Todd W. Gehr, MD, Richmond, VA; Janelle Gonyea, RD, LD, Rochester, MN; Joanna Q. Hudson, PharmD, Memphis, TN; M. Alison Hull, MPH, RD, LD, Anchorage, AK; Kamyar Kalantar-Zadeh, MD, Orange, CA; Joel D. Kopple, MD, Torrance, CA; Nadiya Lakhani, RDN, CSR, LD, Dallas, TX; Edgar V. Lerma, MD, Chicago, IL; J. Matthew Luther, MD, Nashville, TN; Tom Manley, RN, CRNA, Madison, WI; Scott McClure, PhD, Baltimore, MD; Jose A. Menoyo, MD, San Mateo, CA; R. Curtis Morris, MD, San Francisco, CA; Suzanne Oparil, MD, Birmingham, AL; Amit Sharma, MD, Redwood City, CA; David Spiegel, MD, Redwood City, CA; David St-Jules, RDN, PhD, New York, NY; Francesca Tentori, MD, Ann Arbor, MI; Stewart A. Turner, PhD, San Mateo, CA; Angela Yee-Moon Wang, MD, PhD, Hong Kong, China; Adam T. Whaley-Connell, DO, Columbia, MO; Karen Wiesen, MS, RD, LD, Danville, PA; Kerry Willis, PhD, New York, NY; Daniel Wilson, MD, Redwood City, CA; Charles S. Wingo, MD, Gainesville, FL; and Randall Mark Zusman, MD, Boston, MA. Support: Relypsa (developer of patiromer calcium) and ZS Pharma (developer of sodium zirconium cyclosilicate) provided grants to NKF and ASH to support the conference. The conference sponsors had no role in the development of the conference agenda or objectives. The sponsors were restricted from viewing any part of the conference report manuscript until it was accepted for publication and therefore had no role in the content developed for this report. Kerry Willis, PhD, and Tom Manley from the NKF assisted in meeting logistics, facilitation of author communications, and collation of manuscript references. Financial Disclosure: Dr Kovesdy is a consultant to Relypsa and Astra Zeneca, Dr Townsend is a consultant to Relypsa, Dr Grams has a grant from the NKF. Dr Pitt is a consultant to Relypsa, KBP Pharmaceuticals, Ardelyx, Bayer, Davinci Therapeutics, Merck, Takeda, Boehringer Ingelheim, AstraZeneca, PharMain, Sarfez Pharmaceuticals, scPharmaceuticals, Tricidia, Aurasense, and Forest Laboratories; owns stock options in Relypsa, KBP Pharmaceuticals, Davinci Therapeutics, PharMain, scPharmaceuticals, and Aurasense; and has a patent pending for site-specific delivery of eplerenone to the myocardium. The remaining authors declare that they have no other relevant financial interests. Peer Review: Evaluated by 2 external peer reviewers, with editorial input from an Acting Editor-in-Chief.
Publisher Copyright:
© 2017 Published jointly in American Journal of Kidney Diseases and the Journal of the American society of Hypertension by Elsevier Inc, on behalf of the National Kidney Foundation and the American Society of Hypertension.
PY - 2017/12
Y1 - 2017/12
N2 - While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia. Fear of this often asymptomatic finding limits enthusiasm for recommending potassium intake and often limits the use of renin-angiotensin-aldosterone system blockers in patients with heart failure and chronic kidney diseases. New agents for managing hyperkalemia may alter the long-term management of heart failure and the hypertension, proteinuria, and further function loss in chronic kidney diseases. In this jointly sponsored effort between the American Society of Hypertension and the National Kidney Foundation, 3 panels of researchers and practitioners from various disciplines discussed and summarized current understanding of the role of potassium in health and disease, focusing on cardiovascular, nutritional, and kidney considerations associated with both hypo- and hyperkalemia.
AB - While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia. Fear of this often asymptomatic finding limits enthusiasm for recommending potassium intake and often limits the use of renin-angiotensin-aldosterone system blockers in patients with heart failure and chronic kidney diseases. New agents for managing hyperkalemia may alter the long-term management of heart failure and the hypertension, proteinuria, and further function loss in chronic kidney diseases. In this jointly sponsored effort between the American Society of Hypertension and the National Kidney Foundation, 3 panels of researchers and practitioners from various disciplines discussed and summarized current understanding of the role of potassium in health and disease, focusing on cardiovascular, nutritional, and kidney considerations associated with both hypo- and hyperkalemia.
KW - Potassium
KW - cardiovascular disease (CVD)
KW - chronic kidney disease (CKD)
KW - dietary intake
KW - heart disease
KW - hyperkalemia
KW - hypokalemia
KW - patiromer calcium (RLY5016)
KW - potassium homeostasis
KW - potassium secretion
KW - renal excretion
KW - review
KW - sodium zirconium cyclosilicate (ZS-9)
KW - sodium-polystyrene sulfonate
UR - http://www.scopus.com/inward/record.url?scp=85030772462&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030772462&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2017.09.003
DO - 10.1053/j.ajkd.2017.09.003
M3 - Article
C2 - 29029808
AN - SCOPUS:85030772462
SN - 0272-6386
VL - 70
SP - 844
EP - 858
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 6
ER -