At AstraZeneca, we are relentless in our pursuit of developing and delivering innovative, life-changing medicines and solutions for the millions of people affected by the complex spectrum of Cardiovascular, Renal and Metabolic (CVRM) diseases.
With an impressive CVRM legacy, we are positioned to build a healthier future for people living with CVRM diseases by working collaboratively with physicians, patients and advocacy organisations to reimagine patient care.
With this goal in mind, we set out to better understand the global state of hyperkalaemia (HK) management for people living with chronic kidney disease (CKD) and heart failure (HF) and went directly to patients and healthcare professionals (HCPs) for answers. HK, or high levels of potassium in the blood, is a potentially serious medical condition that occurs in 24% to 48% of patients with moderate to advanced CKD and/or HF1, making it a common complication that can be life-threatening if severe and left untreated.2 Additionally, the risk for HK is increased for patients who take common life-saving medications for CKD and HK, such as RAAS-inhibitors which can increase potassium in the blood. Conducted by AstraZeneca, the Global State of Hyperkalaemia Survey (GSHS) was fielded to 1,001 patients with CKD or HF and 500 HCPs (cardiologists and nephrologists) across five countries (Italy, Japan, Spain, UK and US). 3 With it, we set out to understand HCP and patient insights to uncover potential awareness gaps where opportunities exist to advance clinical practice and patient care.
Findings show HCPs recognize the importance of HK, yet find it difficult to treat and awareness among patients remains low.
While HCPs reported mentioning the importance of HK management to their CKD or HF patients, this didn’t necessarily translate to strong awareness of the condition among patients. 3 Indeed, many patients (66%) surveyed are unaware that HK is a potential complication of their condition, and patients, on average, only recognise 3 out of 10 symptoms that were put forward.3
However, a lack of awareness does not equate to a lack of interest. When questioned, most patients (68%) want to learn more about HK from their specialists, but around one-third of HCPs surveyed did not feel comfortable discussing HK with their patients.3 This lack of awareness among patients and perception that HK is difficult to treat could be leading to potentially devastating impacts for some of those living with CKD or HF.
What could help to improve the global state of HK in patients with CKD and HF?
If patients are unaware of HK as a condition related to their disease, it presents challenges for HCPs to be able to manage it. Hyperkalaemia continues to be seen as difficult to treat by all HCPs, regardless of speciality or market, with both nephrologists and cardiologists agreeing there is a need for clearer guidelines and management strategies. 3
The survey revealed HCP concerns around management and diagnosis of HK:
- Only 34% of HCPs find HK easy to manage.3
- 56% of HCPs would like more information about guidelines to follow if a patient is diagnosed with HK and how to classify the condition.3
- When diagnosis does happen, HCPs find it challenging to collaborate with patients’ other HCPs that are part of their continuum of care – which could prevent them from finding tailored solutions for their patients.3
Clearer guidelines and management strategies that address these concerns could provide HCPs with the tools to effectively manage HK and increase patient awareness.
How can we use these insights to improve HK management and awareness?
We will continue to leverage the findings from the GSHS to advance conversations around HK and raise the profile of HK as a key consideration for HCPs and patients living with CKD or HF. This requires collaborative action from all stakeholders to use data-driven insights, to inform the necessary tools needed to transform patient care.
In the meantime, patients can engage with their local advocacy groups to raise awareness of HK. HCPs can also advance the care of their patients by implementing the guidelines that do exist, including the recently updated European Society of Cardiology guidelines on the diagnosis and management of acute and chronic HF which include new information on HK management in HF patients4). From a global perspective, healthcare systems around the world should consider updating their HK treatment guidelines to align with KDIGO’s global recommendations.5
Armed with global insights from pragmatic data such as the GSHS, we see a hopeful future for patients living with or at risk of HK. Through improved awareness and management, not only can we collectively work to improve the global state of HK management, but we can continue to advance our understanding of CVRM diseases to enable people to live a life less burdened by their diagnosis.
1. Latts LM et al. Hyperkalemia Is Prevalent in Patients with Cardiorenal Comorbidities. presented at: ISPOR 20th Annual International Meeting, 2015 May 16 - 20, Philadelphia PA.
2. Rosano GMC et al. Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: Coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J Cardiovasc Pharmacother 2018; 4(3):180–8.
3. Global State of Hyperkalaemia Survey Key Findings, REF-129958, AstraZeneca Pharmaceuticals LP. Veeva ID: Z4-38799. Date of preparation: October 2021.
4. European Heart Journal, Volume 42, Issue 36, 21 September 2021, Pages 3599–3726, Published: 27 August 2021
5. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int Suppl. 2020;98:S1-S115.