A Newly Recognized DXA Confounder: The Potassium-Binding Medication Sodium Zirconium Cyclosilicate

McCarney, Brenda; Binkley, Neil; Krueger, Diane

doi:10.1016/j.jocd.2020.05.008

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…These findings are compatible with previous reports on titanium, zirconium, and binary titanium–zirconium composite dental implants and the artifacts in multimodal imaging found in patients possessing such implants [ 5 ], and on the impact of zirconium implants on image quality [ 6 ]. SZC is also a possible confounder when performing a bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DEXA) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Angioi,

Floris,

Lepori

et al. 2023

Renal Failure

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Sodium Zirconium Cyclosilicate (SZC) is commonly used for treating hyperkalemia because it sequesters gastrointestinal potassium ions, thereby reducing serum potassium levels. However, a less-discussed aspect of SZC is its radiopacity on x-ray-based imaging techniques. The European Medicines Agency (EMA) has only vaguely addressed this issue. Radiopaque substances like SZC can interfere with diagnostic imaging, creating challenges for clinicians and radiologists. We present the case of a 34-year-old Italian male to illustrate these concerns.

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Section: Discussionmentioning

confidence: 99%

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Angioi,

Floris,

Lepori

et al. 2023

Renal Failure

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“…Moreover, SZC may alter bone mineral density and body composition phantom measurements because of its contrast-like effect. 4 These characteristics of the new drug, widely used for hyperkalemia, should be recognized.…”

Section: Discussionmentioning

confidence: 99%

Opaque Densities in the GI Tract of a Patient Treated for Hyperkalemia

2023

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“…If the patient is having abdominal X-rays, radiographers should keep this in mind" [3]. In addition, one study mentions that Lokelma ® may alter dual-energy X-ray absorptiometry (DXA) by altering measurements of bone mineral density and body composition phantom measurements which were both statistically significant [4]. There are no available (DXA) or abdominal X-ray images for the patient in this presentation.…”

Section: Discussionmentioning

confidence: 99%

Radiopacity of sodium zirconium cyclosilicate on CT imaging

et al. 2021

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A patient who post-operatively develops hyperkalemia is treated with sodium zirconium cyclosilicate (Lokelma ® ), a novel agent used for the treatment of non-life-threatening hyperkalemia with reduced side effects as compared with its predecessors. On CT imaging of the chest, abdomen, and pelvis, a radiopaque fluid is noticed despite the patient not having received any oral or intravenous contrast nor any medications or supplements that may appear radiopaque. Based on previous CT imaging of zirconium-based tooth implants and their radiopaque appearance on images, it is hypothesized that the sodium zirconium cyclosilicate that the patient was administered is the explanation of the radiopacity on CT imaging. We performed an in-vitro experiment to confirm that Lokelma is radiopaque to support our hypothesis. It is important to fully understand the differential of what may cause different appearances on imaging as well as to eliminate potential sources of artifact prior to imaging, or alternatively, to potentially be able to use medications with known radiopaque properties as alternatives to contrast agents.

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A Newly Recognized DXA Confounder: The Potassium-Binding Medication Sodium Zirconium Cyclosilicate

Cited by 3 publications

References 13 publications

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Opaque Densities in the GI Tract of a Patient Treated for Hyperkalemia

Radiopacity of sodium zirconium cyclosilicate on CT imaging

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