[Pharmacology of hyperkalemia].

Acute and chronic hyperkalemia (HK) is a frequent occurrence in patients with heart failure resulting from decreased renal function, dysfunctional homoeostatic mechanisms and the effect of cardiovascular drugs. Drugs such as renin-angiotensin-aldosterone system inhibitors (RAASi), angiotensin receptor-neprilysin inhibitor and beta-blockers can cause drug-induced HK by interfering with potassium excretion. Up until now therapies for acute and chronic HK have been limited to drugs that can be used in the acute and sub-acute phase. However, new therapeutic options for the acute and chronic therapy of HK have become available in recent years. Patiromer and sodium zirconium cyclosilicate are effective for both the acute and long-term treatment of HK in patients with cardio-renal syndrome and in those with heart failure. These medicines significantly reduce serum potassium in patients with HK on RAASi and enable the use and up-titration of RAASi in patients who are not optimally treated.