SAT-070 PATIROMER vs. SODIUM POLYSTYRENE SULFONATE: COMPARISON OF POTASSIUM BINDING EFFICACY AND IMPACT ON SODIUM, CALCIUM, AND MAGNESIUM CONTENT OF INFANT MILK FORMULA SIMILAC PM 60:40

摘要

Introduction: Hyperkalemia is one of the common metabolic ab-normalities seen in patients with acute kidney injury (AKI) andchronic kidney disease (CKD). Management of this condition in-cludes combination of low-potassium diet with additional potas-sium-binding medications if necessary. However, these measuresare impractical in infants whose dietary intake is predominantlymilk. Both breast as well as the commonly used renal milk for-mula, Similac PM 60:40, have significant potassium and manyinfants with CKD manifest hyperkalemia. Low-potassium milkformulas such as Renastart? and Renalcal? are not readilyavailable, and treatment with potassium-binding medications is notpractical at this age. Pretreatement of milk with sodium poly-styrene sulfonate (Kayexalate?) has been utilized over the last 20years as an effective means of reducing the potassium content ofmilk. As Kayexalate exchanges sodium for potassium, it results inextra sodium load that is undesirable in patients with hyperten-sion; moreover, Kayexalate also binds calcium thus decreasingcalcium intake. Patiromer (Veltassa?), a recently introduced so-dium-free potassium-binding polymer exchanges calcium for po-tassium thus avoiding both hypernatremia and hypocalcemia.