title: Randomized Clinical Trial of Sodium Polystyrene Sulfonate for the Treatment of Mild Hyperkalemia in CKD.
abstract: OBJECTIVE
  Hyperkalemia affects up to 10% of patients with CKD. Sodium polystyrene sulfonate has long been prescribed for this condition, although evidence is lacking on its efficacy for the treatment of mild hyperkalemia over several days. This study aimed to evaluate the efficacy of sodium polystyrene sulfonate in the treatment of mild hyperkalemia.
  
  
  METHODS
  In total, 33 outpatients with CKD and mild hyperkalemia (5.0-5.9 mEq/L) in a single teaching hospital were included in this double-blind randomized clinical trial. We randomly assigned these patients to receive either placebo or sodium polystyrene sulfonate of 30 g orally one time per day for 7 days. The primary outcome was the comparison between study groups of the mean difference of serum potassium levels between the day after the last dose of treatment and baseline.
  
  
  RESULTS
  The mean duration of treatment was 6.9 days. Sodium polystyrene sulfonate was superior to placebo in the reduction of serum potassium levels (mean difference between groups, -1.04 mEq/L; 95% confidence interval, -1.37 to -0.71). A higher proportion of patients in the sodium polystyrene sulfonate group attained normokalemia at the end of their treatment compared with those in the placebo group, but the difference did not reach statistical significance (73% versus 38%; P=0.07). There was a trend toward higher rates of electrolytic disturbances and an increase in gastrointestinal side effects in the group receiving sodium polystyrene sulfonate.
  
  
  CONCLUSIONS
  Sodium polystyrene sulfonate was superior to placebo in reducing serum potassium over 7 days in patients with mild hyperkalemia and CKD.
authors.affiliation: Department of Pharmacy and.
authors.forename: Laurence
authors.initials: L
authors.lastname: Lepage
authors.affiliation: Department of Pharmacy and.
authors.forename: Anne-Claude
authors.initials: AC
authors.lastname: Dufour
authors.affiliation: Department of Pharmacy and.
authors.forename: Jessica
authors.initials: J
authors.lastname: Doiron
authors.affiliation: Department of Pharmacy and.
authors.forename: Katia
authors.initials: K
authors.lastname: Handfield
authors.affiliation: Department of Pharmacy and.
authors.forename: Katherine
authors.initials: K
authors.lastname: Desforges
authors.affiliation: Department of Pharmacy and.
authors.forename: Robert
authors.initials: R
authors.lastname: Bell
authors.affiliation: Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada; Department of Medicine.
authors.forename: Michel
authors.initials: M
authors.lastname: Vallée
authors.affiliation: Department of Pharmacy and.
authors.forename: Michel
authors.initials: M
authors.lastname: Savoie
authors.affiliation: Faculty of Pharmacy, and.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Perreault
authors.affiliation: Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada; Department of Medicine.
authors.forename: Louis-Philippe
authors.initials: LP
authors.lastname: Laurin
authors.affiliation: Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada; Department of Medicine, Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada Department of Pharmacology, University of Montreal, Montreal, Canada; and.
authors.forename: Vincent
authors.initials: V
authors.lastname: Pichette
authors.affiliation: Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada; Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada Department of Pharmacology, University of Montreal, Montreal, Canada; and jean-philippe.lafrance@umontreal.ca.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lafrance
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D015536:Down-Regulation; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011137:Polystyrenes / Q000009:adverse effects / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood*; D011792:Quebec; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D011137:Polystyrenes; C003321:polystyrene sulfonic acid; D011188:Potassium
keywords: double-blind method; humans; hyperkalemia; kidney failure, chronic; outpatients; polystyrene sulfonic acid; polystyrenes; potassium; randomized controlled trial; renal insufficiency, chronic