New Perspectives on Treatment Protocols: Kidney International® Publishes Late-breaking Clinical Trials
Two significant research studies were accepted as late-breaking clinical trials at Kidney Week 2024 and have subsequently been published in Kidney International®.
The POISE-3 trial’s analysis found no benefit in targeting a higher intraoperative mean arterial pressure (MAP ≥ 80 mm Hg) compared to the standard MAP ≥ 60 mm Hg in preventing acute kidney injury (AKI) in non-cardiac surgery patients. Despite significant differences in blood pressure management and antihypertensive medication cessation, both groups had similar rates of AKI, suggesting the lower MAP target is sufficient for most patients. These results challenge the assumption that higher MAP prevents AKI and highlights the need for more individualized approaches.
This study explores a personalized approach to reducing cardiac arrhythmias in dialysis patients by adjusting dialysate potassium concentrations and using sodium zirconium cyclosilicate to control hyperkalemia. Results from a pilot trial show that a higher dialysate potassium concentration (3 mEq/l) combined with the binder reduced atrial fibrillation and clinically significant arrhythmias compared to a lower concentration (2 mEq/l). The findings suggest a potential for precision medicine in dialysis care, though further, larger studies are needed to confirm long-term benefits.
