Impact of Potassium‐Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation
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2025
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| author | Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang |
| author_facet | Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang |
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| contents | Impact of Potassium‐Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang Clinical Transplantation ABSTRACT Background Following kidney transplantation (KTx), episodes of hyperkalemia are common and effectively treated with sodium zirconium cyclosilicate (SZC, Lokelma) or patiromer (PAT, Veltassa). The presence of SZC/PAT in the gastrointestinal tract may, if radio dense, influence the interpretation of lumbar spine (LS) dual‐energy x‐ray absorptiometry (DXA)‐scans. We investigated the effect with/without PAT/SZC in KTx on LS DXA readings. Methods A prospective, single‐center study of KTx recipients in need of potassium‐lowering therapy was performed. All participants performed two LS DXA‐scans, the first after at least 3 days of SZC/PAT treatment and the second after a 2‐week washout. Results Eighteen KTx patients (8 SZC, 10 g/day vs. 10 PAT, 8.4 g/day) were included and provided two valid DXA‐scans (mean age 63 ± 12 years, 12 males). The change in LS BMD determinations in the SZC group was 2.48 ±12.21%, while there was no change in the PAT group, ‐0.25 ± 2.28%. The absolute root mean squared difference (RMSD) change was 0.102 ± 0.084 g/cm 2 and 0.021 ±0.013 g/cm 2 after SZC and PAT washout, respectively ( p = 0.008). Conclusion In KTx, treatment with SZC, but not PAT, significantly influenced the DXA‐scan interpretation of the LS region. After a 2‐week washout period, SZC interference was without clinical implications on DXA‐scans. Summary The potassium lowering drug sodium zirconium cyclosilicate (Lokelma) is radiopaque and therefore acts as a confounder on DXA interpretations in kidney transplant recipients. Patiromer (PAT, Veltassa) has no such effect. 10.1111/ctr.70352 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70352 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70352 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Impact of Potassium‐Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang Clinical Transplantation Impact of Potassium‐Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation Anders Åsberg Karsten Midtvedt Jørn Petter Lindahl Hege Pihlstrøm Jens Bollerslev Kristin Godang Clinical Transplantation ABSTRACT Background Following kidney transplantation (KTx), episodes of hyperkalemia are common and effectively treated with sodium zirconium cyclosilicate (SZC, Lokelma) or patiromer (PAT, Veltassa). The presence of SZC/PAT in the gastrointestinal tract may, if radio dense, influence the interpretation of lumbar spine (LS) dual‐energy x‐ray absorptiometry (DXA)‐scans. We investigated the effect with/without PAT/SZC in KTx on LS DXA readings. Methods A prospective, single‐center study of KTx recipients in need of potassium‐lowering therapy was performed. All participants performed two LS DXA‐scans, the first after at least 3 days of SZC/PAT treatment and the second after a 2‐week washout. Results Eighteen KTx patients (8 SZC, 10 g/day vs. 10 PAT, 8.4 g/day) were included and provided two valid DXA‐scans (mean age 63 ± 12 years, 12 males). The change in LS BMD determinations in the SZC group was 2.48 ±12.21%, while there was no change in the PAT group, ‐0.25 ± 2.28%. The absolute root mean squared difference (RMSD) change was 0.102 ± 0.084 g/cm 2 and 0.021 ±0.013 g/cm 2 after SZC and PAT washout, respectively ( p = 0.008). Conclusion In KTx, treatment with SZC, but not PAT, significantly influenced the DXA‐scan interpretation of the LS region. After a 2‐week washout period, SZC interference was without clinical implications on DXA‐scans. Summary The potassium lowering drug sodium zirconium cyclosilicate (Lokelma) is radiopaque and therefore acts as a confounder on DXA interpretations in kidney transplant recipients. Patiromer (PAT, Veltassa) has no such effect. 10.1111/ctr.70352 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Impact of Potassium‐Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70352 |