Heart and Renal Failure

Polymer pills turn out "lytes" in chronic HF with renal disease

Belgrade, Serbia - Could plastics at least partly take over the job of diuretics in chronic heart failure?

Patients with advanced HF and renal dysfunction who daily swallowed a handful of capsules containing an electrolyte- and fluid-binding polymer showed meaningful gains in symptom and functional status over eight weeks, according to researchers from the small study [1,2].

Dr Maria Rosa Costanzo

"It's almost like giving a sponge that traps the water. And because of the chemical structure, it traps sodium and potassium as well and eliminates them through the stool," Dr Maria Rosa Costanzo (Midwest Heart Foundation, Naperville, IL) told heartwire.

She presented the 113-patient, double-blind randomized trial here last week at the Heart Failure Congress 2012 of the European Society of Cardiology Heart Failure Association. It was simultaneously published online in the European Journal of Heart Failure.

Patients with advanced heart failure are typically on diuretics despite well-documented concerns about their renal safety, Costanzo noted. It's possible that gastrointestinal elimination of fluid, sodium, and potassium could supplement diuretic therapy in such patients, allowing lower diuretic dosages, or benefit those with diuretic resistance.

That is the hope for the cross-linked polyelectrolyte (CLP) polymer (Sorbent Therapeutics, Sunnyvale, CA) tested in the phase 2 trial, which entered only heart-failure patients in NYHA class 3-4 at high risk of fluid overload, renal insufficiency, and a clear indication for aldosterone blockade—in this casespironolactone (which is also a potassium-sparing diuretic)./.../