Abstract
Background. The use of sodium polystyrene sulfonate in decreasing serum potassium has recently been questioned due to the lack of documented effectiveness. Methods. A retrospective cohort analysis of all hospitalized patients who received sodium polystyrene sulfonate over four months was performed. The change in serum potassium was noted over a period of 24 hours. Patients who received any other form of potassium-altering drug or treatment were excluded. Results. The administration of sodium polystyrene sulfonate reduced serum potassium by 16.7% (P < 0.001) as compared to the baseline serum potassium over a period of 24 hours. During this same time, no change in serum creatinine was identified (P = 0.73). In addition, there was no correlation between potassium and creatinine change (r2 = 0.0004 and P = 0.99). Patients with higher initial serum potassium (≥5.6 mEq/L) reduced their potassium concentration 4% more than those with initial serum potassium of <5.6 mEq/L; however, this reduction did not reach statistical significance (P = 0.32). There was no significant difference in the effectiveness of 15 gm and 30 gm resin preparation (P = 0.54). Thirteen deaths were noted in our cohort, of which one death was due to ischemic colitis. Conclusion. We conclude that sodium polystyrene sulfonate is effective in lowering serum potassium.
Highlights
Sodium polystyrene sulfonate (SPS) is a cation exchange resin used for the treatment of hyperkalemia
Potassium continued to decline over 24 hours and reached its minimum during 18 to 24 hours interval; there was no significant change in potassium between 12.5–18 hours and >18 hours intervals (P = 0.147)
No change was noted in the proportion of change in creatinine concentration during the same time period (P = 0.73) (Figure 3(b))
Summary
Sodium polystyrene sulfonate (SPS) is a cation exchange resin used for the treatment of hyperkalemia. Despite its widespread use as a treatment modality for hyperkalemia, there is a paucity of data on SPS effectiveness in lowering serum potassium in human subjects. Due to these considerations, a recent review stated SPS use to be “largely unproven and potentially harmful” [20]. The administration of sodium polystyrene sulfonate reduced serum potassium by 16.7% (P < 0.001) as compared to the baseline serum potassium over a period of 24 hours. During this same time, no change in serum creatinine was identified (P = 0.73). We conclude that sodium polystyrene sulfonate is effective in lowering serum potassium
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