- A single dose of sodium polystyrene sulfonate (SPS) reduces hyperkalemia in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Why this matters
- SPS use in this population is widespread despite lack of sufficient efficacy data.
- Gastrointestinal safety remains unclear.
- Study of 114 adults with CKD (stage IV, 30%; stage V, 14%) or dialysis-dependent ESRD (56%), and serum potassium >5 (median, 5.7) mEq/L.
- Patients (mean age, 66 years; 52% women) received a single dose of 15 mg (n=53) or 30 mg (n=61) SPS, suspended in 33% sorbitol.
- Funding: None.
- Potassium levels were evaluated at a median 14 (interquartile range [IQR], 10-18) hours after 30 g SPS and 16 (IQR, 12-19) hours after 15 g SPS.
- Median potassium decreased by SPS dose (IQRs):
- 30 g: 0.8 mEq/L (0.4-1.1 mEq/L; P<.001>
- 15 g: 0.5 mEq/L (0.2-0.9 mEq/L; P<.001>
- 15 or 30 g SPS: 0.7 mEq/L (0.4-1.0 mEq/L; P<.001 significance retained in esrd-only analysis meq>
- Single-center, retrospective design.
- Mostly mild hyperkalemia.