Comparing potassium binders for treating high potassium levels in the ER

Comparison of Potassium Binders in the ER

Phase 4 Interventional University of California, Irvine · NCT04585542

This study is testing which of three different medications works best to lower high potassium levels in adults who come to the Emergency Room.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment120 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity of California, Irvine Academic / other
Locations1 site (Orange, California)
Trial IDNCT04585542 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to compare the efficacy of three oral potassium binders—sodium polystyrene sulfate, patiromer, and sodium zirconium cyclosilicate—against a non-specific laxative in patients presenting with acute hyperkalemia in the Emergency Room. Adult patients with plasma potassium levels greater than 5.5 mEq/L will be randomized to receive one of the medications, along with standard hyperkalemia therapy. Blood potassium levels will be monitored at 2 and 4 hours post-administration, and participants will complete a questionnaire regarding symptoms and medication palatability. The goal is to identify the most effective treatment for lowering potassium levels in this acute setting.

Who should consider this trial

Good fit: Ideal candidates for this study are adults aged 18 and older with elevated plasma potassium levels greater than 5.5 mEq/L who can provide informed consent.

Not a fit: Patients who may not benefit from this study include those with recent bowel surgery, active psychiatric disorders, or those requiring immediate dialysis.

Why it matters

Potential benefit: If successful, this study could provide a more effective treatment option for patients with acute hyperkalemia, potentially improving patient outcomes in emergency situations.

How similar studies have performed: Other studies have explored the use of potassium binders, but this specific comparison of binders in an emergency setting is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Plasma potassium \> 5.5 mEq/L
* Age ≥18 years
* Patient able to provide written informed consent

Exclusion Criteria:

* Recent bowel surgery
* Ileus or bowel obstruction
* Pseudohyperkalemia signs and symptoms, such as excessive fist clenching, hemolyzed blood specimen, severe leukocytosis or thrombocytosis
* Pregnancy
* Active psychiatric disorder
* Diabetic ketoacidosis or hyperkalemia caused by any condition for which a therapy directed against the underlying cause of hyperkalemia would be a better treatment option
* Dialysis session expected within 4 hours after randomization
* History of hypersensitivity to sodium polystyrene sulfonate resin or patiromer
* Concurrent use of sorbitol (due to increased risk of intestinal necrosis when used with sodium polystyrene sulfonate)

Where this trial is running

Orange, California

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Acute HyperkalemiaOral Potassium BindersEmergency Department
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.