sodium zirconium cyclosilicate is an inorganic, nonabsorbable crystalline compound that exchanges both sodium and hydrogen ions for potassium throughout its intestinal transit.
Urgency of treatment of hyperkalemia varies with the severity of the potassium elevation, symptomatic versus asymptomatic and the cause of hyperkalemia. − Patients who have muscle weakness or paralysis, cardiac arrhythmias), serum potassium >6.5 mEq/L), and patients with moderate hyperkalemia (serum potassium >5.5 mEq/L) plus significant renal impairment and ongoing tissue breakdown need to be treated emergently., sodium zirconium cyclosilicate is not indicated for emergent treatment of hyperkalemia in such situations.
patients with hyperkalemia who do not require urgent lowering of the serum potassium. example - chronic, mild (≤5.5 mEq/L) or moderate (5.5 to 6.5 mEq/L) elevations in serum potassium due to chronic kidney disease (CKD) or the use of medications that inhibit the renin-angiotensin-aldosterone system ([RAAS] or both) can be treated with sodium zirconium cyclosilicate
Zirconium cyclosilicate is also effective for management of hyperkalemia among patients receiving maintenance hemodialysis. In the DIALYZE study, 196 patients receiving maintenance hemodialysis who had persistent predialysis hyperkalemia were randomly assigned to treatment with zirconium cyclosilicate (5 to 15 g orally on nondialysis days) or placebo for eight weeks. Treatment success, defined as a predialysis serum potassium (following the long interdialytic interval) of 4.0 to 5.0 mEq/L during the last four weeks of therapy, was more common with zirconium cyclosilicate (41 versus 1 percent)
Reference
Sodium Zirconium Cyclosilicate: A Review in Hyperkalaemia - PubMed (nih.gov)
Sodium Zirconium Cyclosilicate - PMC (nih.gov)
