Sodium Zirconium Cyclosilicate Lowers Hyperkalemia After Parathyroidectomy

NCT ID: NCT05382988

Last Updated: 2022-05-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2021-12-31

Brief Summary

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Sodium zirconium cyclosilicate (SZC) has been demonstrated for its serum potassium-lowering efficacy and safety in hyperkalemia hemodialysis patients.

However, the effects of SZC during the perioperative period remained unknown.

This experiment aimed to determine whether using SZC would impact the serum potassium levels in patients with maintenance hemodialysis after parathyroidectomy (PTX).

Detailed Description

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Secondary Hyperparathyroidism (SHPT) is a common and severe manifestation of chronic kidney disease (CKD), especially in end-stage renal disease (ESRD) patients. SHPT is characterized by elevated parathyroid hormone (PTH) synthesis and secretion accompanied by parathyroid cell hyperplasia.Elevated PTH level is considered as a risk factor for fracture, hyperphosphatemia, anemia, and cardiovascular calcification that worsens the health-related quality of life and increases mortality.

Parathyroidectomy (PTX) has been considered the first-line treatment for severe SHPT. Generally, approximately 29% of patients with end-stage renal disease undergo parathyroidectomy to control secondary hyperparathyroidism. Successful PTX may rapidly reduce serum PTH levels and alleviate clinical symptoms.

Postoperative hyperkalemia is one common complication after PTX. With an incidence of 25-80%, in previous research, hyperkalemia has been reported during and immediately after PTX, leading to devastating consequences.

SZC increases fecal potassium excretion and lowers serum potassium levels by binding potassium ions, demonstrated to reduce serum potassium to normal levels within 48 hours in hyperkalemia patients.

Nevertheless, the effects of SZC during the perioperative period remained unknown.

Sixty-two patients with secondary hyperparathyroidism (SHPT) were randomly recruited into the experimental and control groups. Patients in the experimental group were required to take SZC 10g before PTX. Laboratory chemistries, including serum potassium levels, serum calcium levels and serum PTH were obtained before and after surgery. We aimed to determine whether using SZC would impact the serum potassium levels in patients with maintenance hemodialysis after parathyroidectomy (PTX).

Conditions

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Sodium Zirconium Cyclosilicate Hyperkalemia Hyperparathyroidism, Secondary

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

All patients had dialysis within 24h before PTX, then were treated with PTX in Otolaryngology Head and Neck Surgery department in Guangdong Provincial People's Hospital by one experienced surgeon. The experimental group was required to take SZC 10g immediately after the blood test at 6 am, while no medical treatment was performed on patients in the control group.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental Group

The experimental group was required to take SZC 10g at 6 am on the day of surgery.

Group Type EXPERIMENTAL

Sodium zirconium cyclosilicate

Intervention Type DRUG

The experimental group was required to take SZC 10g at 6 am on the day of surgery.

Control Group

No additional intervention was performed

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Sodium zirconium cyclosilicate

The experimental group was required to take SZC 10g at 6 am on the day of surgery.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Secondary Hyperparathyroidism (SHPT) is a common and severe manifestation of chronic kidney disease (CKD), especially in end-stage renal disease (ESRD) patients. ESRD MHD with SHPT patients were recruited into this study

Exclusion Criteria

* Patients with severe cardiovascular disease who cannot tolerate general anesthesia surgery were not included in this study.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Guangdong Provincial People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Shuangxin Liu, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Guangdong Provincial People's Hospital

References

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Kang J, Li S, Su J, Xiao Z, Zhang S, Liu S, Ge P. Effect of sodium zirconium cyclosilicate on hyperkalemia after parathyroidectomy in secondary hyperparathyroidism patients with maintenance hemodialysis: A randomized trial. Medicine (Baltimore). 2024 Dec 27;103(52):e40917. doi: 10.1097/MD.0000000000040917.

Reference Type DERIVED
PMID: 39969301 (View on PubMed)

Other Identifiers

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SZC AFTER PTX

Identifier Type: -

Identifier Source: org_study_id

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