Sodium zirconium cyclosilicate (Lokelma) to enable Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) use in the treatment of patients with diabetic kidney disease
Authors' conclusion
SZC reduced hyperkalemia-related RAASi discontinuation risk, improved proteinuria and BP, supporting its prophylactic use in DKD patients on RAASi.
Study context
- Population
- Diabetic kidney disease (DKD) patients at hyperkalemia risk
- Participants
- 86 patients
- Comparison
- Sodium zirconium cyclosilicate (SZC) + ACEIs/ARBs vs ACEIs/ARBs alone
- Primary endpoint
- ACEIs/ARBs dose up-titration
- Follow-up
- Week 12
Methodological detailsprospective, multicenter, 24-week follow-up
- Prospective
- Multicenter
- 24-week follow-up
Primary result
As reported in the abstract
P = 0.009
Further findings
| Outcome | SZC + ACEIs/ARBs | ACEIs/ARBs | Least squares mean difference (mg/g) (95% CI) | |
|---|---|---|---|---|
| UACR change (exploratory) · week 24Per-Protocol Set | decreased by 63.46 mg/g | increasing by 316.87 mg/g | −333.63 (−1148.73 to 481.47) | |
| −1500−1000−5000500Difference, mg/g (linear scale) |
Blood pressure (BP) reduction (exploratory)
mmHg
- BP reductions numerically greater with SZC + ACEIs/ARBs: systolic
- −1.7
- BP reductions numerically greater with SZC + ACEIs/ARBs: diastolic
- −1.4
Original publication
Sodium zirconium cyclosilicate (Lokelma) to enable ACEIs/ARBs use in the treatment of patients with diabetic kidney disease. Diabetes Res Clin Pract. Published 9 August 2025. doi:10.
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