A recent clinical trial called CREDENCE has uncovered that canagliflozin, a sodium-glucose cotransporter 2 (SGLT2), can reduce hyperkalemia risk in chronic kidney disease (CKD) and type 2 diabetes patients who have been treated with a renin-angiotensin-aldosterone system (RAAS) inhibitor.
Results from this study were published in the European Heart Journal.
CREDENCE
In this investigation, 4,401 patients who had type 2 diabetes, as well as CKD, were randomized to either receive a placebo or canagliflozin. At baseline, the average serum potassium level for patients was 4.5 mmol/L. Almost all patients received the maximum dose of RAAS.
The research team found that the canagliflozin treatment was linked with a lower prevalence of hyperkalemia (investigator reported) or the initiation of potassium binders. Risk was reduced by 22% with the treatment when compared with the placebo.
Further, the treatment reduced laboratory-determined hyperkalemia by 23% without increasing substantially the risk of hypokalemia.
Between the treatment group and the placebo group, mineralocorticoid receptor antagonists and potassium-sparing diuretics were similar. The researchers concluded that these variables did not determine the outcomes between groups.
Over the course of the study, both groups experienced similar increases in average serum potassium, indicating a decline in kidney function.
This research team ultimately explained that canagliflozin has the potential to reduce hyperkalemia risk in those diagnosed with CKD and type 2 diabetes and that this treatment does not have a negative effect on hypokalemia risk. In the future, they hope to study the effect of this treatment on CKD patients who don’t have diabetes.
Additionally, the team is working on prospective studies in an effort to confirm what was found in this initial trial and to specify the exact mechanisms of action. You can read more about this novel therapy here.
