Kidney Care UK welcomes new guidance from the National Institute for Health and Care Excellence (NICE) that extends access to a treatment for hyperkalaemia (high potassium levels), a common condition in people with kidney problems.
Your kidneys help to remove excess potassium from the body in the form of urine (wee). When people have chronic kidney disease (CKD), their kidneys do not work as well as they should, which means they cannot get rid of the extra potassium, causing it to build up in the blood. This does not always cause obvious symptoms, but people with hyperkalaemia may notice symptoms including tiredness, stomach pain or nausea, dizziness and more. Severe hyperkalaemia can be life-threatening.
Read more about hyperkalaemia including symptoms and treatment.
- NICE already recommends sodium zirconium cyclosilicate (also known as SZC, or by its brand name Lokelma®) for people with acute life-threatening hyperkalaemia and where persistently high potassium levels prevent people from taking the optimum level of blood pressure medication (renin-angiotensin-aldosterone system RAAS inhibitors).
- For this second group, this update lowers the required potassium level to receive SZC from at least 6.0 mmol per litre to 5.5 mmol per litre. This is important because optimal RAAS inhibitor treatment slows kidney disease progression and reduces risk of death.
SZC is not recommended for people on dialysis.
- In addition, once it has been initiated by a specialist doctor, people who need SZC treatment for persistent high potassium will be able to access repeat prescriptions from their GP meaning fewer trips to the hospital.
We recommend you speak to your GP or kidney team if you have any questions about hyperkalaemia or this treatment.
Update – 29 April 2026: This draft decision was taken under a new government policy which extends the amount the government will pay for access to new drugs, provided they are cost-effective. Kidney Care UK will be monitoring how this new process works for people with kidney disease.