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By Joe Weatherly FM/Hospitalist-CoFounder of QuestioningMedicine and PCRAP contributor.
Richard H Sterns, Marvin Grieff, Paul L Bernstein
Treatment options for hyperkalemia have not changed much since the introduction of the cation exchange resin, sodium polystyrene sulfonate (Kayexalate, Covis Pharmaceuticals, Cary, NC), over 50 years ago. Although clinicians of that era did not have ready access to hemodialysis or loop diuretics, the other tools that we use today-calcium, insulin, and bicarbonate-were well known to them. Currently recommended insulin regimens provide too little insulin to achieve blood levels with a maximal kalemic effect and too little glucose to avoid hypoglycemia...
March 2016: Kidney International
Mazen Albeldawi, Varun Gaur, Luke Weber
A 61-year-old male presents to the emergency room with complaints of fatigue, dizziness and bright red blood per rectum (BRBPR) for 2 days. Past medical history was significant for gastroesophageal reflux disease, non-steroidal anti-inflammatory drug (NSAID) induced ulcer, and end-stage renal disease (GFR < 30) status post 2 failed renal grafts. Pertinent medications include pantoprazole and sodium polystyrene sulfonate in sorbitol (Kayexalate 30 g/d orally). On esophagogastroduodenoscopy (EGD) there was a single shallow, flat, non-bleeding gastric ulcer (3 mm) in the pre-pyloric region of the stomach with no stigmata of bleeding...
August 2014: Gastroenterology Report
Ryan C Romano, Seshadri Thirumala, Walter H Cushman, Taofic Mounajjed
Kayexalate (sodium polystyrene sulfonate), a cation exchange resin often used to treat hyperkalemia, is known to produce gastrointestinal complications in a minority of patients. These complications range from mild gastrointestinal bleeding to perforation with acute abdomen. The typical histopathologic findings include mucosal ulceration, necrosis, and the presence of polygonal basophilic refractile crystals with a "fish scale" appearance. We present a unique case of Kayexalate crystals embedded in a perihepatic inflammatory pseudotumor, developing adjacent to a colostomy site in a 62-year-old woman following Kayexalate treatment...
August 2014: International Journal of Surgical Pathology
Kirsten Thompson, Joseph Flynn, Daryl Okamura, Li Zhou
OBJECTIVE: To evaluate the effect on serum potassium of treating infant formula or expressed breast milk (EBM) with sodium polystyrene sulfonate (SPS) before patient consumption. DESIGN AND SETTING: Retrospective cohort study of patients at Seattle Children's Hospital who received SPS-treated formula or EBM. SUBJECTS AND INTERVENTION: Thirteen patients less than 2 years of age with a diagnosis of hyperkalemia and acute kidney injury or chronic kidney disease that had received formula or EBM pretreated with SPS between September 2009 and May 2012 were identified...
September 2013: Journal of Renal Nutrition
Ziv Harel, Shai Harel, Prakesh S Shah, Ron Wald, Jeffrey Perl, Chaim M Bell
BACKGROUND: Sodium polystyrene sulfonate (Kayexalate; Sanofi-Aventis, Paris, France) is a cation-exchange resin routinely used in the management of hyperkalemia. However, its use has been associated with colonic necrosis and other fatal gastrointestinal adverse events. Although the addition of sorbitol to sodium polystyrene sulfonate preparations was previously believed to be the cause of gastrointestinal injury, recent reports have suggested that sodium polystyrene sulfonate itself may be toxic...
March 2013: American Journal of Medicine
Emmanuel C Gorospe, Jason T Lewis, David H Bruining
No abstract text is available yet for this article.
May 2012: Clinical Gastroenterology and Hepatology
Yueh-Hung Chou, Hsin-Yi Wang, Min-Shu Hsieh
Kayexalate (sodium polystyrene sulfonate) is a cation-exchange resin used to treat patients with hyperkalemia. Concomitant administration of kayexalate and sorbitol may induce gastrointestinal injury, which is potentially lethal. However, this well-documented complication is often underrecognized both clinically and pathologically. We propose a typical case along with colonoscopic photos and microscopic pictures. Additionally, we also present a review of the literature on this rare drug-induced side effect.
April 2011: Kaohsiung Journal of Medical Sciences
Anish Thomas, Bridgit Rose James, David Landsberg
Kayexalate (sodium polystyrene sulfonate in sorbitol) is commonly used for treatment of hyperkalemia. We describe the case of a critically ill patient who developed colonic necrosis after oral administration of kayexalate.
April 2009: American Journal of the Medical Sciences
Hakam Yaseen, Mona Khalaf, Ahmed Dana, Noha Yaseen, Maha Darwich
Our objective was to compare the efficacy and safety of rectal cation-exchange resin (Kayexalate) versus salbutamol infusion for the treatment of nonoliguric hyperkalemia (NOHK) in preterm infants. Data of all neonates born with NOHK during the study period of 6 years and 8 months were recorded. Diagnostic criteria of NOHK included serum potassium (SK) concentration > or = 7 mmol/L during the first 72 hours of life with urine output > or = 1 mL/kg/hour. This before-after study was divided according to the date of admission; the first 15 patients were treated with Kayexalate enema 1 g/kg every 4 hours, and the remaining 30 patients were treated with intravenous salbutamol infusion as 4 mug/kg every 4 hours...
March 2008: American Journal of Perinatology
Michael O Idowu, Michelle Mudge, Nitya R Ghatak
No abstract text is available yet for this article.
January 2005: Archives of Pathology & Laboratory Medicine
S C Abraham, B S Bhagavan, L A Lee, A Rashid, T T Wu
Kayexalate (sodium polystyrene sulfonate) in sorbitol has been demonstrated to cause colonic necrosis in a subset of uremic patients who are administered the cation exchange resin for treatment of hyperkalemia. Upper gastrointestinal damage associated with Kayexalate in sorbitol is reported far less frequently, and the clinicopathologic spectrum of disease in cases with upper gastrointestinal damage has not been investigated previously. The authors studied the clinical, endoscopic, and histologic features of 11 patients with Kayexalate crystals in biopsies from the esophagus (n = 7), stomach (n = 6), and duodenum (n = 2)...
May 2001: American Journal of Surgical Pathology
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