Many of us who live with kidney disease know how often the word “potassium” comes up in clinic letters, medicine reviews and blood-test conversations. Keeping the right balance of this everyday mineral in our bodies is part of the careful background work of life with CKD, and when levels creep upwards it can be worrying. New draft guidance from NICE, announced this April, could now open a tried-and-tested high potassium treatment to many more people across the UK.
What is the new high potassium treatment NICE has recommended?
According to Kidney Research UK, the National Institute for Health and Care Excellence has published draft guidance that recommends the medicine sodium zirconium cyclosilicate, usually shortened to SZC, for adults living with persistent hyperkalaemia (high blood potassium) who also have chronic kidney disease at stages 3b to 5, or heart failure.
The key change is the threshold. Under the new draft, treatment becomes an option when blood potassium sits at 5.5 mmol per litre or above, rather than the previous 6.0 mmol per litre. It applies to patients who cannot yet take the full protective doses of their RAAS inhibitors because of high potassium, and to those already receiving dialysis.
If the draft is finalised, NICE estimates that the number of kidney and heart-failure patients eligible for this high potassium treatment in England could more than double.
Read the full summary from Kidney Research UK.
Why this matters for kidney patients
For many of us, the real day-to-day challenge is not simply eating carefully but making sure that the blood pressure medicines that protect the kidneys can stay in the plan at the right strength. RAAS inhibitors — medicines like ramipril, losartan and similar — are among the most effective tools for slowing CKD and easing strain on the heart, but they can nudge potassium upwards. When levels climb, doctors often have to reduce or pause them, which can feel like trading one kind of protection for another.
A wider availability of SZC could change that calculation. By giving another safe high potassium treatment option that works alongside potassium in the body through diet, it could allow more patients to stay on the doses of RAAS inhibitors their kidney and cardiology teams would like them to have. For people in Greater Manchester and the North West, this is particularly relevant – our busy renal and cardiology services at Manchester Royal Infirmary and across the region look after thousands of patients juggling exactly these decisions every year.
Draft Guidance
It is worth being clear that this is draft guidance. Until NICE finalises its decision, prescribing practice will not change overnight, and every individual treatment plan still needs to be made with your renal or heart-failure team. This follows a broader recent pattern of NICE’s decisions on kidney medicines, where each recommendation is weighed carefully against evidence and cost. If you have questions about your own potassium levels or your current medicines, your renal team remains the best source of advice.
Hearing that NICE is opening this high potassium treatment up to more of us is genuinely encouraging. Many MRIKPA members have sat in clinic worrying about potassium results, and knowing there are more tools on the table can take a little of that weight off. We will keep following the final guidance closely and share what it means for kidney patients in plain language.
– Guy Hill, Chair of MRIKPA
At MRIKPA, we are a patient-led community based around the Manchester Royal Infirmary, made up of people who live with kidney disease and those who care for them. We have walked through plenty of clinic visits ourselves and know how much a friendly conversation can help on a difficult day. If you would like to connect with others who truly understand from the inside, you are welcome to get in touch at support@mrikpa.org.uk or on 07745 242 684.
Source: Kidney Research UK, April 2026 – read the original article
This article is provided for general information and awareness purposes only and was believed to be accurate at the time of publishing. It is not intended as medical advice — please always consult your doctor or renal team for guidance on your individual circumstances. Images used are for illustration purposes only and may not be medically or editorially accurate. While we take every care, errors can occur. If you spot an inaccuracy, please let us know at support@mrikpa.org.uk.
