Comparison Among Potassium Binders on the Management of Hyperkalemia on Chronic Dialysis Patients: A Protocol for Systematic Review.

Introduction. Treating hyperkalemia is one of the main goals of supportive care in patients on hemodialysis. In this context, therapy with new potassium binders is a promising resource. Objective. The main aim is to evaluate the difference in serum potassium concentration after treatment with sodium zirconium cyclosilicate or patiromer compared to placebo/sodium polystyrene sulfonate/calcium polystyrene sulfonate. Methods. We will perform systematic research in PubMed, EMBASE, CINAHLE, and grey literature will be screened. We will screen RCTs on patients treated with SZC or patiromer in chronic hemodialysis, without sex or age restriction, which include the differences in serum potassium concentration, adverse events (AEs), and mortality as outcomes. Expected results. This systematic review is expected to provide a comprehensive evaluation of the efficacy and adverse effects of new potassium binders, compared to sodium polystyrene sulfonate or calcium polystyrene sulfonate or placebo, on serum potassium concentration, in a sample of hemodialysis patients. Furthermore, possible gaps in actual knowledge can be highlighted, suggesting new research. Conclusions. The present protocol for a systematic review will consider all existing evidence from published RCTs about the efficacy of HIF-PHIs on hemodialysis patients.