Evidano is an AI-powered qualitative data analysis platform that helps researchers analyze interviews, open-ended surveys, and documents. According to PLOS One, the study "Navigating the potassium dilemma" interviewed 12 practising nephrologists in Spain in October 2025 to explore how clinicians manage hyperkalaemia while trying to preserve renin–angiotensin–aldosterone system inhibitor (RAASi) therapy. The PLOS One paper was published on July 30, 2026 and reports that 75% of participants had more than 15 years of experience and that binder prescribing in the prior 12 months was split 50/50 between patiromer and sodium zirconium cyclosilicate (SZC). This post explains the PLOS One findings through the lens of AI-enabled qualitative research and shows how researchers can use Evidano to replicate and extend that kind of analysis.
Key Takeaways
According to PLOS One, Spanish nephrologists use a stepwise algorithm to manage hyperkalaemia aimed at preserving RAASi therapy where possible, but access barriers limit use of newer potassium binders. The PLOS One study interviewed 12 nephrologists in October 2025 and was published on July 30, 2026.
- 12 nephrologists were interviewed in October 2025, with interviews averaging 53 minutes, according to PLOS One (Gimenez-Stamminger et al., 2026).
- The PLOS One sample reported that 75% of participants had more than 15 years of clinical experience as of October 2025.
- PLOS One reports that binder use in the prior 12 months was evenly distributed: 50% patiromer and 50% SZC, reflecting clinician adoption by 2025.
- PLOS One identifies five themes in July 2026: stepwise potassium control, newer binders enabling RAASi continuity, system-level access barriers, the central role of nursing and patient communication, and limited routine HRQoL measurement.
What Happened and how the PLOS One study was done
PLOS One conducted semi-structured interviews with 12 hospital-based nephrologists across six Spanish regions in October 2025 to explore real-world hyperkalaemia management.
PLOS One reports that the research team transcribed interviews verbatim, used ATLAS.ti for analysis, and developed a codebook that produced 30 final codes organised into 15 sub-themes and five overarching themes.
PLOS One states that participants were selected purposively, all had at least three years of practice and had prescribed both traditional resins and at least one newer binder in the prior 12 months.
Findings Snapshot
| Date (source) | Metric | Value | Implication (as reported) |
|---|---|---|---|
| October 2025 (PLOS One) | Number of interviews | 12 nephrologists | Qualitative sample size justified by data sufficiency |
| October 2025 (PLOS One) | Interview length | Average 53 minutes | Depth sufficient for thematic coding |
| Prior 12 months (reported in PLOS One, 2026) | Binder prescribing | 50% patiromer, 50% SZC | Clinician experience with both newer binders |
| July 30, 2026 (PLOS One publication) | Themes identified | 5 overarching themes, 15 sub-themes | Structured insights into clinical, system and patient factors |
Implications for clinical researchers and nephrology teams
The PLOS One findings mean that researchers should treat clinician accounts of RAASi preservation as hypothesis-generating rather than causal evidence because the study captured perspectives not patient outcomes.
PLOS One highlights that system-level barriers such as _visado_ prior authorisation and regional formulary variation create delays that clinicians perceive as contributing to RAASi discontinuation.
PLOS One reports that formal health-related quality-of-life measurement was infrequent in routine care, implying that future mixed-methods studies should add validated PROMs to capture the patient burden clinicians described.
How Evidano helps: from interview transcript to actionable themes
Problem: manual transcript coding is slow and inconsistent
Solution: Evidano automates thematic and codebook-based analysis while preserving audit trails to mirror the ATLAS.ti workflow described in PLOS One.
Contextual link: Learn more on Evidano features.
Problem: extracting quantitative markers from qualitative data (eg, code frequencies, quotes) is laborious
Solution: Evidano generates code frequencies, co-occurrence matrices, and extractable quote tables so researchers can replicate the PLOS One step of turning 30 codes into 15 sub-themes quickly.
Problem: multi-source synthesis (transcripts, guidelines, policies) is error-prone
Solution: Evidano ingests documents and spreadsheets, aligns citations, and provides AI chat over your dataset so teams can ask evidence-first questions like "Which clinicians cited _visado_ as a barrier? "
Problem: stakeholder reporting needs clear, auditable outputs
Solution: Evidano exports reproducible reports and visualisations (word clouds, code trees, co-occurrence networks) that map directly to the themes PLOS One identified, supporting policy-facing briefings and grant proposals.
FAQ: qualitative hyperkalaemia management
What were the main clinical strategies nephrologists used for hyperkalaemia in Spain?
Answer: The PLOS One study reports a structured, stepwise clinical algorithm combining dietary counselling, diuretics, metabolic correction, and selective use of potassium binders to preserve RAASi therapy.
Supporting detail: PLOS One quotes a participant: "I structure the management in a stepped way: first line, diet and diuretics; second line, bicarbonate or binders; third line, reduction or suspension of drugs that increase potassium, as a last resort." (ID05), which illustrates the reported stepwise logic.
Do newer potassium binders enable continued RAASi use according to this qualitative sample?
Answer: According to PLOS One, nephrologists perceived newer binders (patiromer and SZC) as enablers of RAASi continuity rather than only potassium-lowering agents.
Supporting detail: PLOS One includes clinician testimony such as, "The arrival of the new binders has been a revolution. I have not had to dialyse patients urgently for hyperkalaemia for years, thanks to these treatments." (ID09).
What system barriers limited adoption of newer binders in the PLOS One study?
Answer: PLOS One identifies administrative prior authorisation (_visado_), regional formulary differences, and fragmented cross-specialty communication as primary barriers to timely access.
Supporting detail: PLOS One documents clinician concerns that emergency departments sometimes discharge patients with suspended RAASi and no reinitiation plan, increasing the risk of prolonged RAASi interruption.
How can AI assist replication or extension of this qualitative study?
Answer: AI-enabled platforms can accelerate coding, quantify code frequencies, extract illustrative quotes, and produce reproducible audit trails that match the codebook approach used by PLOS One.
Supporting detail: Using AI to process transcripts reduces manual time per interview, lets teams test intercoder reliability at scale, and supports rapid scenario analysis for policy or economic modelling.
Conclusion & Next Steps
The PLOS One qualitative study (published July 30, 2026) finds that Spanish nephrologists prioritise RAASi preservation and view newer potassium binders as important enablers, while noting access and coordination barriers that limit implementation.
PLOS One shows gaps that are ripe for mixed-methods follow-up: quantify RAASi persistence, measure HRQoL with validated PROMs, and evaluate the policy impact of prior authorisation rules.
If you are designing a qualitative or mixed-methods study to test these hypotheses, Evidano can accelerate transcription, codebook-based thematic analysis, and reproducible reporting so your team moves from transcripts to policy-ready evidence faster.
Ready to test it on your data? Try Evidano for free.