spironolactone + patiromer

Spironolactone + patiromer is a combination therapy used primarily in patients with resistant hypertension and chronic kidney disease (CKD) to enable the continued use of spironolactone by preventing hyperkalemia. Spironolactone is a potassium-sparing diuretic and aldosterone receptor antagonist that promotes sodium and water excretion while retaining potassium, making it effective for conditions such as heart failure, hypertension, edema, and hyperaldosteronism[2][6]. However, its use can be limited by the risk of hyperkalemia, especially in CKD patients. Patiromer is an oral potassium-binding polymer that lowers serum potassium levels by binding free potassium in the gastrointestinal tract for excretion[1][8]. Clinical trials (such as AMBER) have shown that adding patiromer allows more patients to remain on spironolactone without developing significant hyperkalemia[3][4][5].