title: To bind or to let loose: effectiveness of sodium polystyrene sulfonate in decreasing serum potassium.
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 (r(2) = 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.
authors.affiliation: Division of Nephrology, University of Rochester Medical Center, 601 Elmwood Avenue, P.O. Box 675, Rochester, NY 14642, USA.
authors.forename: Shaifali
authors.initials: S
authors.lastname: Sandal
authors.forename: Hatim
authors.initials: H
authors.lastname: Karachiwala
authors.forename: John
authors.initials: J
authors.lastname: Noviasky
authors.forename: Dongliang
authors.initials: D
authors.lastname: Wang
authors.forename: William C
authors.initials: WC
authors.lastname: Elliott
authors.forename: David F
authors.initials: DF
authors.lastname: Lehmann