Sodium zirconium cyclosilicate post hospital discharge to prevent hyperkalaemia: phase 4, randomized CONTINUITY trial
Clicks: 1
ID: 314068
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
0.0
/100
1 views
0 readers
AI Quality Assessment
Not analyzed
Readership in this journal
Ranked #92 of 128 articles by views in clinical kidney journal
Most read
Least read
Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 128 in total.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
Abstract Background and Hypothesis Hyperkalaemia is common and potentially life-threatening in individuals with chronic kidney disease (CKD). While sodium zirconium cyclosilicate (SZC) is used in the hospital setting for hyperkalaemia management, few patients are discharged with a continuing prescription, leaving them at risk of recurrent hyperkalaemia and rehospitalization. The CONTINUITY study aimed to establish the efficacy of continuing post-hospital discharge treatment with SZC versus standard of care (SOC) in maintaining normokalaemia and reducing all-cause and hyperkalaemia-related hospital admissions and emergency department visits in patients with CKD and hyperkalaemia. Methods This phase 4, randomized, controlled, open-label, parallel-group, multicentre study 28 sites; six European countries; 24 March 2022–10 December 2024) included participants aged ≥ 18 years admitted to hospital with diagnosed CKD (any stage) and hyperkalaemia [serum potassium (sK+) > 5.0 and ≤ 6.5 mmol/L] without ongoing K+ binder treatment. Participants received SZC for 2–21 days to normalize sK+. Those with normokalaemia (3.5–5.0 mmol/L) at discharge were randomized to SZC or SOC. The primary objective was occurrence of normokalaemia at 180 days post-discharge [those achieving normokalaemia (responders) vs those who did not (non-responders)]. Results The difference between arms for normokalaemia responders was not statistically significant: 30.9% (SZC) and 36.2% (SOC) (odds ratio 0.81; 95% CI 0.39–1.66; P = 0.558). High and imbalanced levels of missing sK+ measurements at 180 days (n = 35 [51.5%] in the SZC arm and n = 25 [36.2%] in the SOC arm) led to substantially lower levels of normokalaemia response than the original assumptions in the sample size calculations used to power the study. Conclusion The study did not meet its primary endpoint. Study design limitations may have masked true treatment effects. Post hoc analyses revealed positive trends in SZC use and potential for reducing rehospitalization and enabling renin-angiotensin-aldosterone system inhibitor therapy continuation at optimal doses.
| Reference Key |
openalex_W7161637781
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | James O Burton, María J Izquierdo, Cecilia Linde, Nicolás R Robles, Manish M Sood, Alaster M Allum, James M Eudicone, Magnus Dahl, Alpesh N Amin |
| Journal | clinical kidney journal |
| Year | 2026 |
| DOI |
10.1093/ckj/sfag158
|
| URL | |
| Keywords | Keywords not found |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.