Treatment Patterns of Patients with Hyperkalaemia Receiving Sodium Zirconium Cyclosilicate in Greece: A Multicenter Prospective Study

Background/Objectives: Hyperkalaemia affects 2–4% of the general population. Real-world data in Greece are currently limited. The SHIELD study assessed treatment patterns and disease management of patients with hyperkalaemia in Greece. Methods: This prospective, multicenter, observational study was conducted in 12 hospital-based nephrology and cardiology units across Greece, with 11 having enrolled patients. The study enrolled patients with hyperkalaemia and chronic kidney disease (CKD) on dialysis or not, or heart failure (HF) under RAASi/MRAs, receiving sodium zirconium cyclosilicate (SZC), with a 6-month follow-up. Results: Overall, 125 patients participated in the study (51.2% CKD non-dialysis, 25.6% CKD on dialysis, and 23.2% HF patients receiving RAASi/MRAs), with a mean age of 64.7 years. At SZC initiation, the overall median serum potassium was 5.6 mmol/L (range: 5.1–7.7). At Visits 1, 2, and 3, the most frequently reported potassium monitoring interval was monthly (44.8%, 40.0%, and 41.4%, respectively). The overall median eGFR as calculated by CKD-EPI 2021 equation changed from 30.0 mL/min/1.73 m2 at baseline to 24.5 at 3 months, and 27.0 at 6 months. CKD non-dialysis patients mostly received 10 g SZC daily, dialysis patients 5 g on non-dialysis days and HF patients 5 g daily, with limited changes over time. SZC plus an RAASi/MRA, mostly ARBs (72.2%), was administered to 63.2% of patients at baseline and 3 months, increasing to 69.0% at 6 months. A total of 84.8% of patients received antihypertensive, 56.8% lipid-lowering, 39.2% antiplatelet, 40.0% antidiabetic and 4.8% corticosteroid agents. Conclusions: The SHIELD study provides real-world evidence on patient characteristics, monitoring practices, and treatment patterns, including the combination of SZC and RAASi/MRAs, in patients with hyperkalaemia in Greece.