The randomized DIALIZE-Outcomes trial evaluated sodium zirconium cyclosilicate in hemodialysis.

Overall, 2690 participants were randomized. The trial was terminated early due to low event rates (∼33% of planned) and high study medication discontinuation rates, limiting generalizability of the results. No treatment effect was observed on the primary composite end point (SZC, 8.8% [119 patients] vs. placebo, 8.9% [119 patients]; hazard ratio 0.98; 95% confidence interval 0.76-1.26) or individual cardiovascular outcomes. SZC did not demonstrate a treatment effect on arrhythmia-related cardiovascular outcomes despite efficacy on serum potassium control.