Article
Medicine, General & Internal
Takashin Nakayama, Shintaro Yamaguchi, Kaori Hayashi, Kiyotaka Uchiyama, Takaya Tajima, Tatsuhiko Azegami, Kohkichi Morimoto, Tadashi Yoshida, Jun Yoshino, Toshiaki Monkawa, Takeshi Kanda, Hiroshi Itoh
Summary: Hyperkalemia is a common electrolyte abnormality in patients with chronic kidney disease (CKD). This retrospective study compared the effect of the potassium binders sodium zirconium cyclosilicate (ZSC) and calcium polystyrene sulfonate (CPS) on serum potassium (K+) levels in CKD patients. The ZSC group showed a greater reduction in K+ levels and an increase in serum sodium minus chloride levels compared to the CPS group. These findings suggest that ZSC may be beneficial in improving hyperkalemia and metabolic acidosis in CKD patients.
FRONTIERS IN MEDICINE
(2023)
Article
Emergency Medicine
Shannon Hasara, Jesse Dubey, John Amatea, Nancy Finnigan
Summary: This study aimed to evaluate the efficacy and safety of SPS and SZC in lowering serum potassium levels in patients presenting to the ED with hyperkalemia. It was a retrospective cohort study conducted at a single-site ED, and the primary outcome was the change in serum potassium following SPS or SZC administration. The results showed that both SPS and SZC resulted in similar reductions in serum potassium levels.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Urology & Nephrology
Mats Nagard, Bhupinder Singh, David W. Boulton
Summary: The study suggests that sodium zirconium cyclosilicate can effectively reduce serum potassium concentration and urinary potassium excretion, with no significant impact on urinary sodium excretion, and is well tolerated.
CLINICAL KIDNEY JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Min Zhuo, Seoyoung C. Kim, Elisabetta Patorno, Julie M. Paik
Summary: This study aimed to investigate whether there is a difference in the risk of hospitalization for heart failure (HHF) between the initiation of sodium zirconium cyclosilicate (SZC) and patiromer for the treatment of hyperkalemia. The results from the matched analysis showed that the use of SZC was associated with a numerically higher risk of HHF compared to patiromer, but this difference did not reach statistical significance.
JOURNAL OF CARDIAC FAILURE
(2022)
Article
Pharmacology & Pharmacy
Alison Rydell, Corianne Thackrey, Maryam Molki, Brandon P. Mullins
Summary: This study compared the effectiveness of patiromer and sodium zirconium cyclosilicate (SZC) in patients with acute hyperkalemia. The results showed no difference between the two medications in reducing serum potassium levels, and no clinically significant differences in electrolyte changes were observed.
ANNALS OF PHARMACOTHERAPY
(2023)
Article
Pharmacology & Pharmacy
Noah Yoo, Yong-Bum Song, Ilya Dubinsky, Jerry Altshuler
Summary: SZC is an inorganic zirconium silicate compound that selectively exchanges potassium for hydrogen and sodium. The once dose regimen of SZC was non-inferior to the once or repeated dosing regimen of SPS in reducing serum potassium levels. There were no significant differences in the rate of additional potassium-lowering therapies and the rate of normokalemia at 48 hours between the SZC and SPS groups.
ANNALS OF PHARMACOTHERAPY
(2023)
Article
Urology & Nephrology
Wakana Kimura, Shun Minatoguchi, Tomohiro Mizuno, Shigehisa Koide, Hiroki Hayashi, Midori Hasegawa, Daijo Inaguma, Naotake Tsuboi
Summary: This study aimed to compare the effect of sodium zirconium cyclosilicate and existing potassium binders on the continuity of RAAS inhibitors in patients with hyperkalemia. The results showed that administering sodium zirconium cyclosilicate to patients with hyperkalemia can increase the use of ACEI/ARB compared to calcium polystyrene sulfonate. This suggests potential benefits of sodium zirconium cyclosilicate for patients with chronic kidney disease receiving RAAS inhibitors.
JOURNAL OF NEPHROLOGY
(2023)
Article
Pharmacology & Pharmacy
Zhaohui Ni, Renhua Lu, Xudong Xu, Xueyan Bian, Zhihong Zhou, Junwei Yang, Qun Luo, Menghua Chen, Chaosheng Chen, Xiuli Sun, Lei Yu, Qiang He, Hong Jiang, Weijie Yuan, Yi Li, Rong Zhou, Jianqin Wang, Xinzhou Zhang, Li Zuo, Xiangwen Meng, Zhiren Chang, June Zhao, Peter Wessman, DIALIZE China Study Grp
Summary: The DIALIZE China study evaluated the effectiveness of Sodium Zirconium Cyclosilicate (SZC) for the management of hyperkalemia in Chinese patients undergoing hemodialysis. The study found that SZC treatment resulted in a significantly higher proportion of responders and improved maintenance of normal serum potassium levels compared to placebo. SZC treatment was safe and effective in Chinese patients with kidney failure receiving hemodialysis.
CLINICAL THERAPEUTICS
(2023)
Article
Medicine, Research & Experimental
Lan Yao, Xiaoyang Xing, Yubao Li, Fangxing Zhang, Ping Li, Xianhui Liang, Pei Wang
Summary: This study evaluated the efficacy and safety of potassium-lowering regimens for acute hyperkalemia in maintenance hemodialysis patients. Results showed that the IG + SZC group had the largest decrease in serum potassium levels at 2 hours, while the SPS group had the smallest decrease. SZC showed similar efficacy to IG intravenous administration in lowering potassium at 2 hours.
JOURNAL OF TRANSLATIONAL MEDICINE
(2022)
Article
Urology & Nephrology
Stephen R. Ash, Daniel Batlle, Jessica Kendrick, Yemisi Oluwatosin, William Pottorf, Yasmin Brahmbhatt, Emily Guerrieri, Linda Fried
Summary: The NEUTRALIZE study aims to investigate the impact of SZC on patients with hyperkalemia and metabolic acidosis associated with chronic kidney disease. The study design is a prospective, randomized, double-blind phase 3b study, primarily examining whether SZC can provide sustained increases in serum bicarbonate.
Article
Public, Environmental & Occupational Health
Lei Tian, Shihui Fu, Mengyuan Li, Xinrui Zhao, Hongchao Li
Summary: This study evaluated the cost-effectiveness of SZC compared to usual care in the treatment of hyperkalemia among CKD patients or HF patients in China. The results showed that SZC is a cost-effective treatment option.
FRONTIERS IN PUBLIC HEALTH
(2023)
Article
Medicine, General & Internal
Shardool Patel, Derek Pinnell, Joshua Qualls, Anitha Rathod, Wei Chen, Sylvie Boutin, Steven D. Woods, Csaba P. Kovesdy, Navdeep Tangri, Brian C. Sauer
Summary: Untreated chronic hyperkalemia is associated with increased mortality risk. Patiromer, a new potassium binder, is being used by clinicians as a management tool. This study assessed patiromer utilization and its effect on serum potassium in US veterans with prior exposure to sodium polystyrene sulfonate.
Article
Pharmacology & Pharmacy
Haley Lewis, Benton Stamper, Alyssa Claudio Yungkurth
Summary: The study aimed to assess the efficacy of single-dose SZC compared to FDA approved TID dosing and single-dose SPS for managing asymptomatic hyperkalemia in hospitalized patients. The results showed that single-dose SZC 10 g achieved a higher proportion of patients reaching normokalemia compared to SZC 10 g x 3 doses, but lower than SPS. Therefore, single-dose SZC may be a reasonable option for managing asymptomatic hyperkalemia in the hospital setting.
Review
Cardiac & Cardiovascular Systems
Yaru Zhang, Ruiling Xu, Fanghao Wang, Youxia Liu, Junying Xu, Na Zhao, Fajuan Cheng, Lihong Long, Junya Jia, Shan Lin
Summary: Oral sodium zirconium cyclosilicate (SZC) effectively reduces serum potassium levels in patients with hyperkalemia within 48 hours, and continued use helps in long-term potassium control, showing a favorable safety profile.
CARDIOVASCULAR DRUGS AND THERAPY
(2021)
Article
Urology & Nephrology
Steven Fishbane, Martin Ford, Masafumi Fukagawa, Kieran McCafferty, Anjay Rastogi, Bruce Spinowitz, Konstantin Staroselskiy, Konstantin Vishnevskiy, Vera Lisovskaja, Ayman Al-Shurbaji, Nicolas Guzman, Sunil Bhandari
Summary: These analyses expand our knowledge of the spectrum of potassium responses with SZC in hyperkalemic hemodialysis patients, and suggest that SZC has better control over potassium gradient compared to placebo.
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2022)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2022)
Review
Emergency Medicine
Christiaan van Nispen, Taylor Reffett, Brit Long, Michael Gottlieb, Thomas C. Frawley
Summary: The outbreak of monkeypox in May and June 2022 is the largest outside of central and western Africa since the 2003 outbreak in the United States. Monkeypox, caused by an orthopoxvirus, has symptoms similar to smallpox but tends to be milder. It is important for healthcare authorities to be involved in the care of patients and for emergency clinicians to be aware of the manifestations and management of this disease.
ANNALS OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Editorial Material
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Editorial Material
Emergency Medicine
Brit Long, Michael Gottlieb
ANNALS OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Krishna Constantino, Michael Gottlieb, Brit Long
Summary: This narrative review provides emergency clinicians with the most recent evidence concerning acute exacerbation of ILD (AE-ILD) for improved evaluation and management.
JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Article
Emergency Medicine
Jonah Gunalda, Dustin Williams, Alex Koyfman, Brit Long
Summary: This article reviews the key points and pitfalls of endophthalmitis, including presentation, diagnosis, and management in the emergency department based on current evidence. Endophthalmitis is a serious condition that threatens vision, associated with infection and inflammation of the vitreous and aqueous humor. Diagnosis should be based on clinical evaluation, though culture performed by ophthalmology specialist is recommended. Imaging can suggest the disease but cannot exclude the diagnosis. Prompt recognition and diagnosis are key to optimizing favorable visual outcomes.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Joshua J. White, John D. Cambron, Michael Gottlieb, Brit Long
Summary: This article provides a narrative review of the diagnosis and management of airway foreign bodies for the emergency clinician, emphasizing the importance of early intervention and airway patency.
JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Alex Koyfman
Summary: Nonconvulsive status epilepticus (NCSE) is a disease characterized by prolonged seizure activity. It is often underdiagnosed due to nonspecific signs and symptoms. Patients primarily present with altered mental status, and other symptoms include abnormal ocular movements and automatisms. Diagnosis involves electroencephalogram (EEG) and clinical observation. Treatment includes addressing life-threatening conditions and stopping the seizure activity.
JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Brit Long, Michael Gottlieb
ACADEMIC EMERGENCY MEDICINE
(2023)
Review
Emergency Medicine
Jessica Pelletier, Alex Koyfman, Brit Long
Summary: This review evaluates the presentation, diagnosis, and management of posterior circulation (PC) stroke in the emergency department. PC stroke commonly presents with dizziness or vertigo and needs to be differentiated from other conditions. Neurologic examination and specific assessment methods are important for identifying stroke-related dizziness. CT scans have limited sensitivity, and MRI is the most accurate diagnostic method. Thrombolysis is recommended for eligible patients, but the applicability of endovascular therapy for PC strokes is yet to be determined.
JOURNAL OF EMERGENCY MEDICINE
(2023)