heart with a picture of two kidneys

Case Study:

Aligned recommendations for managing hyperkalaemia across the cardiorenal spectrum

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Triducive word icon - pink

The Client

Our client is a world leader in treatments supporting nephrology and cardiology patients. They commissioned us to help develop consensus recommendations on the optimal management of hyperkalaemia in the cardiorenal patient using a modified Delphi method. This organisation are a manufacturer of a novel treatment for hyperkalaemia.

kidneys and heart

Therapy Area

Hyperkalaemia is a potentially life-threatening elevation in blood potassium levels that is particularly common amongst patients with cardiorenal comorbidities (e.g. heart failure and chronic kidney disease). Renin angiotensin aldosterone system inhibitors (RAASi) are a mainstay of treatment for cardiorenal patients but are associated with an increased risk of hyperkalaemia. When hyperkalaemia presents, RAASi therapy is often dose reduced or discontinued with subsequent loss of the cardiorenal protection those agents confer.

weighing scales
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Triducive lightbulb tag icon - pink


Opinion exists that RAASi doses should be maintained / increased while the risk or occurrence of hyperkalaemia should be managed with appropriate treatment. Guideline recommendations across cardiology and nephrology specialities vary and leads to variation in clinical practice. This coupled with the fact that cardiologists and nephrologists generally work independently means that best practice is unclear.


Working with the client from mid 2021, we identified the opportunity to implement a Delphi consensus that was designed to:

  • Align perspectives from cardiologists & nephrologists on recommendations for clinical best practice today

  • Help support appropriate updates to future guidelines

Our Process

A multi-disciplinary group of experts specialising in cardiology and nephrology from across Europe and North America were facilitated to pinpoint the challenges related to the management and treatment of hyperkalaemia in the cardiorenal patient, and then define a set of statements that described ‘ideal’ practice

A structured online survey was developed and disseminated across other cardiorenal specialists across Europe and North America. The online survey tested the strength of agreement that existed in relation to the statements developed.

A subsequent facilitated review of the full dataset by the steering group led to the development of a core set of recommendations that reflected the results achieved.  These were focused on the prevention and management of hyperkalaemia in cardiorenal patients.

A manuscript capable of peer-reviewed publication was developed and authored by the steering group. Triducive supported submission to the European Journal of Heart Failure for peer review.


responses achieved from cardiorenal specialists across Europe, US and Canada.


clear recommendations which inform potential improvements to the management of hyperkalaemia in cardiorenal patients

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Published in a high impact peer-reviewed journal which supports credibility and citation of subsequent materials

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Provided a strong platform for the client team to engage with key stakeholders to support updates to guidelines

Outcomes & Observations

Following submission, the manuscript was accepted and subsequently published in mid-2022 in a journal with an impact factor of 17. The study has already been cited in other research (within 1 month of publication) and one National guideline organisation has already initiated a program to redefine its approach. The client have since worked with Triducive to develop campaign activities to build further on this and to drive awareness of the recommended best practice for the prevention and management of hyperkalaemia in cardiorenal patients. Activities include:

  • Clinical meeting materials

  • Congress communications

  • Digital communication campaign assets including an innovative video abstract

“I enjoyed working with Triducive. The team were friendly, helpful and professional and documents were turned around swiftly”

Senior Market Access Manager, Global Pharma

“Triducive are experts in their field and ensure that they keep up to date with the ever-changing industry. They are great strategists and apply extensive experience from a variety of brands and global markets to a project”

Managing Director, Health Consultancy

“I can highly recommend Triducive. They have a real talent for simplifying complex challenges & developing clear communication messages that resonate with the audience”

Executive Director, Medical, Global Pharma

“Triducive works well with our team – they created an innovative customer engagement campaign that we have already seen success with. Triducive was willing to adopt new working practices and adapt with our team”

Franchise Lead, UK Pharma

“I am delighted to say that we have fully approved and rolled-out the value proposition with some great feedback from the team. I have been hugely impressed with the support we have been given by Triducive”

UK Senior Brand Manager

“Triducive have transformed my commercial part of the business”

Director, Global Pharma Company

“Triducive are highly professional and proactive. Their support was highly appreciated by KOLs. We have achieved exactly what we wanted to achieve – which was far from easy”

Senior Global Marketing Leader, Global Healthcare Company

“Triducive met the brief I gave them and delivered a first class meeting. Feedback has been positive. Triducive facilitated the meeting excellently and the reports were of high quality. Triducive helped my thinking during the planning phase and shared what worked with similar meetings”

Regional Market Leader, Top 10 Global Pharma Company

“Triducive are a very professional team that has a perfect balance between listening and doing”

Medical Affairs, Top 10 Global Pharma Company

“Triducive are a great team, they have a strong value proposition (delphi), and are supportive and flexible with their project management. I would certainly recommend Triducive’s services to peers”

Global Commercial Leader, MedTech

“Triducive made the whole experience, simple, straightforward, and hassle-free”

Consultant Cardiologist, NHS

Discover How Triducive Can Help

Find out how Triducive’s amplified Delphi process can help your organisation generate data and advocacy to influence better decisions within the healthcare industry by getting in touch with a member of the Triducive team or schedule a meeting directly with the team today.

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