Association of Proximal Tubule Secretion With Hyperkalemia Risk, Treatment Response, and Outcomes in Heart Failure With Preserved Ejection Fraction
Nicholas Wettersten, Ronit Katz, Pranav S. Garimella, Alexander L. Bullen, Simon B. Ascher, Jesse C. Seegmiller, Yu Horiuchi, Yoshimitsu Takaoka, Joachim H. Ix · 2026
Read Association of Proximal Tubule Secretion With Hyperkalemia Risk, Treatment Response, and Outcomes in Heart Failure With Preserved Ejection Fraction by Nicholas Wettersten, Ronit Katz, Pranav S. Garimella, Alexander L. Bullen, Simon B. Ascher, Jesse C. Seegmiller, Yu Horiuchi, Yoshimitsu Takaoka, Joachim H. Ix (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13396859.txt.
Description
Wettersten and team test, in 2026, whether kidney tubule secretion markers can predict potassium problems and treatment response in heart failure with preserved ejection fraction. They used data from the TOPCAT trial: 372 participants, mean age 70 years, of whom 179 were randomized to the drug spironolactone. A summary score combined urine-to-plasma ratios of nine endogenous secretion markers measured at baseline.
In adjusted models, the score showed no link with changes in serum potassium, the study's central safety question, nor with incident high potassium during follow-up. It also failed to predict symptom improvement, natriuretic peptide changes, or heart and kidney events in the cohort. The single significant finding was modest: higher capacity tracked with a 3.5-point lower heart failure questionnaire score at twelve months, of uncertain weight. The authors conclude these biomarkers should not guide spironolactone decisions or risk prediction in this group.
Catalog record
| CREATOR | Nicholas Wettersten, Ronit Katz, Pranav S. Garimella, Alexander L. Bullen, Simon B. Ascher, Jesse C. Seegmiller, Yu Horiuchi, Yoshimitsu Takaoka, Joachim H. Ix |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 38 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |