alexa
Reach Us +44-7460312890
Letter to the Editor | OMICS International
ISSN: 2329-9517
Journal of Cardiovascular Diseases & Diagnosis
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on Medical, Pharma, Engineering, Science, Technology and Business
All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Letter to the Editor

George Bakris1*, Matthew Weir2 and Murray Epstein3
1ASH Comprehensive Hypertension Center, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Chicago, Chicago, USA
2Division of Nephrology, Department of Medicine, University of Maryland, Baltimore, USA
3Division of Nephrology and Hypertension, University of Miami School of Medicine, Miami, USA
*Corresponding Author : George Bakris, MD, FASN
ASH Comprehensive Hypertension Center
Division of Endocrinology, Diabetes
and Metabolism, Department of Medicine
University of Chicago, Chicago, USA
Tel: + 7737027936
E-mail: [email protected]
Received October 27, 2015; Accepted March 07, 2016; Published March 12, 2016
Citation: Bakris G, Weir M, Epstein M (2016) Letter to the Editor. J Cardiovasc Dis Diagn 4:237. doi:10.4172/2329-9517.1000237
Copyright: © 2016 Bakris G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Cardiovascular Diseases & Diagnosis

We appreciate McCullough et al. extensive review of the interrelationship between cardiovascular and renal diseases (Cardiorenal Syndromes [CRS]: Advances in Determining Diagnosis, Prognosis, and Therapy) [1]. An understanding of the complex cardiorenal axis is of significant clinical importance in the management of patients with dysfunction of these organ systems. This letter serves to highlight inaccuracies and inconsistencies in the article regarding the potassium binders patiromer (recently approved by the FDA as the first new medicine for the treatment of hyperkalemia in more than 50 years) [2] and sodium zirconium cyclosilicate (under development).
Unfortunately, the authors incorrectly describe the amount of calcium as 1.6 g per 4.2 g of patiromer. The correct amount is 1.6 g per 8.4 g of patiromer [3]. While the authors report the amount of the calcium counterion in patiromer, they don’t describe the amount of the sodium counterion in sodium zirconium cyclosilicate. The drug is reported to contain less than ~8% sodium by total weight [4]. Therefore the approximate sodium content in the sodium zirconium cyclosilicate dose tested in clinical trials (10 g) is ~800 mg (35 mEq) sodium.
The authors also incorrectly describe the sorbitol in patiromer as an adjunct cathartic. This is an inaccurate characterization. Sorbitol is part of the calcium counterion complex and improves stability by slowing the rate of elimination of fluoride from the patiromer polymer. The minimum effective dose of sorbitol required to induce a laxative effect in humans is reported as ~50 g [5], approximately 13-fold higher than the 4 g of sorbitol that is present in the typical daily dose of patiromer (8.4 g QD) [3]. The typical dose of sodium polystyrene sulfonate, 45 g/ day, contains ~60 g of sorbitol (for formulations that contain sorbitol), ~15 times the amount of sorbitol in the 8.4 g QD dose of patiromer. The rate of diarrhea observed in patiromer clinical trials was low (4.8%). If the sorbitol content in patiromer was high enough to cause a laxative effect, much higher rates of diarrhea would have been observed.
As noted in the peerâreviewed article by Pitt et al. (Eur Heart J), PEARLâHF was the first prospective doubleâblind, placebo-controlled trial of patiromer to prevent hyperkalemia in chronic HF patients receiving standard therapy including an ACEâI or ARB and beta blocker, in addition to spironolactone 25–50 mg/day [6]. Mean serum K+ at baseline was 4.7 mEq/L in both the patorimer and placebo groups; 41% and 31%, respectively, had a history of HK at baseline. The correct generic name of the approved hyperkalemia therapy is patiromer not patiromer calcium [2].
Acknowledgements
Editorial assistance was provided by Brian J. Catton, PharmD of AlphaBioCom, LLC and funded by Relypsa, Inc.
Conflicts of Interest
Dr. Bakris reports consulting fees from AbbVie; AstraZeneca; Bayer; CVRx; Janssen; Medtronic; Relypsa; and Takeda. Dr. Weir reports consulting fees from Akebia; Amgen; Astra Zeneca; Boston Scientific; Janssen; Lexicon; Merck Sharp & Dohme; Sanofi; Sandoz; and Relypsa. Dr. Epstein reports consulting fees from Bayer; OPKO Health; Novartis; and Relypsa.
References
Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Recommended Conferences

  • International Conference on Hypertension and lifestyle disorders
    November 25-26, 2019 Yokohama, Japan
  • 33rd World Congress on Cardiology & Heart Diseases
    November 25-26, 2019 Rome, Italy
  • International Conference on Cardiology and Heart Failure
    December 02-03, 2019 Tokyo, Japan
  • 34th World Cardiology Conference
    December 02-03, 2019 Barcelona, Spain
  • 2nd Global Conference on Cardiovascular Research and Clinical Cardiology
    December 06-07, 2019 Montreal, Canada

Article Usage

  • Total views: 8528
  • [From(publication date):
    March-2016 - Nov 15, 2019]
  • Breakdown by view type
  • HTML page views : 8389
  • PDF downloads : 139
Top