Reduction of potassium in drinks by pre-treatment with calcium polystyrene sulphonate

Schröder, Cornelis H.; Berg, A.M.J. van den; Willems, J. L.; Monnens, L.A.H.

doi:10.1007/bf01956159

Cited by 20 publications

(12 citation statements)

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“…These results were not due to an inactivity of the resin. In fact, when used in beverages such as orange juice and semi-skimmed milk at a concentration in accordance with previous studies (Bunchman et al, 1991;Fassinger et al, 1998), 4% or 6% Kayexalate Õ induced a dramatic potassium content reduction (about 75%) demonstrating, even when used in small quantity, its stronger efficacy than other resins previously described (Schroder et al, 1993). Therefore, compared to the beverage treatments, one may suggest increasing sodium polystyrene sulfonate content into the soaking or boiling water.…”

Section: Discussionsupporting

confidence: 71%

Effects of water soaking and/or sodium polystyrene sulfonate addition on potassium content of foods

Picq

Asplanato

Bernillon

et al. 2014

International Journal of Food Sciences and Nutrition

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In this study, we determined, by atomic absorption spectrophotometry, the potassium amount leached by soaking or boiling foods identified by children suffering from chronic renal failure as "pleasure food" and that they cannot eat because of their low-potassium diet, and evaluated whether addition of sodium polystyrene sulfonate resin (i.e. Kayexalate®) during soaking or boiling modulated potassium loss. A significant amount of potassium content was removed by soaking (16% for chocolate and potato, 26% for apple, 37% for tomato and 41% for banana) or boiling in a large amount of water (73% for potato). Although Kayexalate® efficiently dose-dependently removed potassium from drinks (by 48% to 73%), resin addition during soaking or boiling did not eliminate more potassium from solid foods. Our results therefore provide useful information for dietitians who elaborate menus for people on potassium-restricted diets and would give an interesting alternative to the systematic elimination of all potassium-rich foods from their diet.

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Section: Discussionsupporting

confidence: 71%

Effects of water soaking and/or sodium polystyrene sulfonate addition on potassium content of foods

Picq

Asplanato

Bernillon

et al. 2014

International Journal of Food Sciences and Nutrition

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“…Currently available sodium and calcium polystyrene sulfonate resins used for the treatment of hyperkalemia are acknowledged to have a gritty texture and unpleasant taste, which can make them difficult for patients to take. 23 , 24 Studies involving other oral medications also show the importance of palatability. Unpleasant taste was associated with poor compliance with therapy in patients receiving antibiotics for the treatment of skin and soft tissue infections, 25 while a survey of elderly patients and their health care professionals showed that compliance with prescribed oral nutritional supplements was low and was affected by taste, texture, and flavor, among other factors.…”

Section: Discussionmentioning

confidence: 99%

Palatability and physical properties of potassium-binding resin RDX7675: comparison with sodium polystyrene sulfonate

Zann¹,

McDermott²,

Jacobs³

et al. 2017

DDDT

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BackgroundHyperkalemia is a potentially life-threatening condition that patients with heart failure or chronic kidney disease, especially those taking renin–angiotensin–aldosterone system inhibitors, are at high risk of developing. Sodium polystyrene sulfonate (SPS), a current treatment, binds potassium within the gastrointestinal tract to reduce potassium absorption. However, poor palatability limits its long-term use. RDX7675, a novel potassium binder in development for the treatment of hyperkalemia, is a calcium salt of a reengineered polystyrene sulfonate-based resin designed to have enhanced palatability. Here, the physical properties and palatability of RDX7675 and SPS are compared.MethodsRDX7675 and SPS particle sizes were measured using wet dispersion laser diffraction. Palatability was assessed in a randomized, crossover, healthy volunteer study with two visits. At visit 1 (open label), volunteers evaluated high-viscosity, intermediate-viscosity, and water-reconstituted formulations of RDX7675 (all vanilla flavor), and an equivalent reconstituted SPS (Resonium A®). At visit 2 (single-blind), volunteers evaluated RDX7675 as a high-viscosity formulation in vanilla, citrus, and mint flavors, and as intermediate-viscosity, low-viscosity, and reconstituted formulations in citrus flavor. Volunteers used a “sip and spit” technique to rate overall acceptability and seven individual characteristics from 1 (“dislike everything”) to 9 (“like extremely”).ResultsRDX7675 particles were smaller than SPS particles, with a narrower size range (RDX7675, 80%, 14–52 µm; SPS, 11.3–124.2 µm), and had a smooth, spherical shape, in contrast to the shard-like SPS particles. Reconstituted RDX7675 was considered superior to SPS for five of the seven palatability characteristics and for overall acceptability (median, visit 1: reconstituted RDX7675, 5.0; SPS, 4.0). High-viscosity vanilla was the most highly rated RDX7675 formulation (median overall acceptability, visit 2: 7.0).ConclusionThe smaller, more uniformly shaped, spherical particles of RDX7675 resulted in improved palatability over SPS when reconstituted in water. The overall results are promising for future patient acceptability of RDX7675 treatment.

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“…For this reason lowering the potassium content of drinks by pre-treatment with calcium polystyrene sulphonate has been suggested [100]. Special care should be taken in patients with end-stage renal failure.…”

Section: Treatmentmentioning

confidence: 99%

Potassium homeostasis and its disturbances in children

Rodríguez‐Soriano

1995

Pediatr Nephrol

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Although only 2% of the body potassium is present in the extracellular space, its concentration is finely regulated by the internal balance, or distribution of potassium between the intracellular and extracellular compartments, and by the external balance, or difference between intake and output of potassium. Internal balance is modulated by a host of factors, including insulin, epinephrine, extracellular pH and plasma tonicity. Potassium output from the body is mainly determined by renal excretion. Renal secretion of potassium takes place predominantly in the principal cells of late distal and cortical collecting tubules, by a process involving the accumulation of potassium in the cell by the activity of the basolateral Na+,K(+)-ATPase and its exit through luminal conductive channels. The factors regulating renal potassium secretion are potassium intake, rate of tubular fluid flow, distal sodium delivery, acid-base status and aldosterone. Hypokalaemia may result from a low potassium intake, excessive gastrointestinal, cutaneous or renal losses and altered body distribution. Aetiological diagnosis and therapy are best accomplished when the acid-base status is assessed at the same time. Before establishing the diagnosis of hyperkalaemia, spurious hyperkalaemia due to haemolysis or release of potassium from cells during clot retraction (pseudohyperkalaemia) should be ruled out. Hyperkalaemia may result from exogenous or endogenous loading, decreased renal output and altered body distribution. Acute hyperkalaemia represents an emergency situation which requires immediate therapy.

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Reduction of potassium in drinks by pre-treatment with calcium polystyrene sulphonate

Cited by 20 publications

References 1 publication

Effects of water soaking and/or sodium polystyrene sulfonate addition on potassium content of foods

Effects of water soaking and/or sodium polystyrene sulfonate addition on potassium content of foods

Palatability and physical properties of potassium-binding resin RDX7675: comparison with sodium polystyrene sulfonate

Potassium homeostasis and its disturbances in children

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