Preserving RAASi: qualitative hyperkalaemia management

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.

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.

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.

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.

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