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NCT04847232

Effect of Sodium Zirconium Cyclosilicate on Arrythmia-related Cardiovascular Outcomes in Participants on Chronic Hemodialysis With Recurrent Hyperkalemia (DIALIZE-Outcomes)

Terminated Phase 3 Results posted Last updated 18 June 2025
What this trial tests

Phase 3 trial testing Sodium Zirconium Cyclosilicate (SZC) in Hyperkalemia in 2,690 participants. Terminated before completion.

Timeline
30 April 2021
Primary endpoint
7 March 2024
7 March 2024

Quick facts

Lead sponsorAstraZeneca
PhasePhase 3
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment2,690
Start date30 April 2021
Primary completion7 March 2024
Estimated completion7 March 2024
Sites340 locations across Italy, Japan, Malaysia, Taiwan, Vietnam, Poland, Russia, Mexico

Drugs / interventions tested

Conditions studied

Sponsor

AstraZeneca — full company profile →

Who can join

Adults 18 to 130, any sex, with Hyperkalemia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Incidence of the Composite of Cardiac Event Outcomes Primary · From Randomization (Visit 4) up to week 129 (Randomized Study Intervention Phase)

Incidence of the composite endpoint of SCD, all stroke, or hospitalization/intervention/emergency department (ED) visit due to arrhythmias is analyzed based on Cox regression model with treatment and region as covariates. Patients with no events are censored at final clinical assessment, death, or disposition event.

GroupValue95% CI
SZC (Active)119
Placebo119
Normokalemia at 12 Months Post-randomization Secondary · Randomization to 12-Month Visit

Logistic regression analysis of whether a subject is Normokalemic (S-K of 4.0 - 5.5 mmol/L ) after the LIDI at the 12-month visit.

GroupValue95% CI
SZC (Active)495
Placebo293
Incidence of the Composite of Arrhythmia Related Events Secondary · From Randomization (Visit 4) up to week 129 (Randomized Study Intervention Phase)

Incidence of the composite endpoint of hospitalization, intervention, emergency department (ED) visit due to arrhythmias is analyzed based on Cox regression model with treatment and region as covariates. Patients with no events are censored at final clinical assessment, death, or disposition event.

GroupValue95% CI
SZC (Active)74
Placebo65

Adverse events — posted to ClinicalTrials.gov

Time frame: From Randomization (Visit 4) up to week 129 (Randomized Study Intervention Phase). Reporting threshold: 3%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

SZC (Active)
Serious: 521/1348 (39%)
Deaths: 120/1348
Placebo
Serious: 503/1338 (38%)
Deaths: 113/1338

Serious adverse events (599 terms)

ReactionSystemSZC (Active)Placebo
PneumoniaInfections and infestations
HyperkalaemiaMetabolism and nutrition disorders
SepsisInfections and infestations
Acute myocardial infarctionCardiac disorders
HypervolaemiaMetabolism and nutrition disorders
Covid-19 pneumoniaInfections and infestations
Arteriovenous fistula thrombosisInjury, poisoning and procedural complications
Covid-19Infections and infestations
Arteriovenous fistula site complicationInjury, poisoning and procedural complications
DeathGeneral disorders
Atrial fibrillationCardiac disorders
Cardiac arrestCardiac disorders
Ischaemic strokeNervous system disorders
Septic shockInfections and infestations
Acute respiratory failureRespiratory, thoracic and mediastinal disorders
Sudden cardiac deathGeneral disorders
CellulitisInfections and infestations
AnaemiaBlood and lymphatic system disorders
Cardiac failureCardiac disorders
Cardiac failure acuteCardiac disorders
HypertensionVascular disorders
Gastrointestinal haemorrhageGastrointestinal disorders
Device related infectionInfections and infestations
GangreneInfections and infestations
Acute pulmonary oedemaRespiratory, thoracic and mediastinal disorders
Other adverse events (16 terms — click to expand)

ReactionSystemSZC (Active)Placebo
HyperkalaemiaMetabolism and nutrition disorders
Covid-19Infections and infestations
DiarrhoeaGastrointestinal disorders
HypertensionVascular disorders
ConstipationGastrointestinal disorders
AnaemiaBlood and lymphatic system disorders
NauseaGastrointestinal disorders
Dialysis hypotensionVascular disorders
VomitingGastrointestinal disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Upper respiratory tract infectionInfections and infestations
HeadacheNervous system disorders
PyrexiaGeneral disorders
PneumoniaInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
Back painMusculoskeletal and connective tissue disorders

Most-reported serious reactions: Pneumonia, Hyperkalaemia, Sepsis, Acute myocardial infarction, Hypervolaemia, Covid-19 pneumonia, Arteriovenous fistula thrombosis, Covid-19.

Data from ClinicalTrials.gov NCT04847232 adverse events section.

Sponsor's own description

The purpose of this study is to evaluate the effect of Sodium Zirconium Cyclosilicate (SZC) on arrhythmia-related cardiovascular outcomes in participants on chronic hemodialysis with recurrent hyperkalemia.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Evaluation of the effect of sodium zirconium cyclosilicate on arrhythmia-related cardiovascular outcomes in patients receiving chronic haemodialysis with hyperkalaemia: protocol for the multicentre, randomised, controlled DIALIZE-Outcomes study.
    Fishbane S, Jadoul M, Dember L, Kovesdy CP, et al · · 2023 · cited 6× · PMID 37230521 · DOI 10.1136/bmjopen-2022-071309
  2. The randomized DIALIZE-Outcomes trial evaluated sodium zirconium cyclosilicate in hemodialysis.
    Fishbane S, Dember LM, Jadoul M, Kovesdy CP, et al · · 2025 · cited 5× · PMID 40618849 · DOI 10.1016/j.kint.2025.06.016
  3. Development of a protocol complexity tool: a framework designed to stimulate discussion and simplify study design.
    Willigers BJA, Wiesiolek AE, Potter B, Pszczółkowska A, et al · · 2025 · PMID 40883682 · DOI 10.1186/s12874-025-02652-9

Verify or expand the search:

Other trials of Sodium Zirconium Cyclosilicate (SZC)

Trials testing the same drug.

Other recruiting trials for Hyperkalemia

Currently open trials in the same condition.

Other AstraZeneca trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing