Risk of Intestinal Necrosis With Sodium Polystyrene Sulfonate: A Systematic Review and Meta‐analysis

Holleck, Jürgen L; Roberts, Andrea; Marhoffer, Elizabeth; Grimshaw, Alyssa; Gunderson, Craig G.

doi:10.12788/jhm.3655

Cited by 10 publications

(9 citation statements)

References 30 publications

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“…However, there can be some adverse gastrointestinal symptoms, such as colonic necrosis, constipation, and bowel obstruction. The risk of severe gastrointestinal effects significantly increased with SPS oral administration, but the risk of intestinal necrosis was not increased [ 65 ]. A higher hospitalization rate for serious gastrointestinal adverse events (intestinal ischemia/thrombosis, gastrointestinal ulceration/perforation, or resection/ostomy) was also observed in old-aged patients within 30 days of SPS use (0.2% vs. 0.04%) [ 66 ].…”

Section: Recommendations Of Treatment For Hyperkalemiamentioning

confidence: 99%

Recent Progresses in Non-Dialysis Chronic Kidney Disease Patients with Hyperkalemia: Outcomes and Therapeutic Strategies

Tian

Zhou

2023

Medicina

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Chronic kidney disease (CKD) affects about 10% of the world’s population. Hyperkalemia is a life-threatening complication in patients with CKD, as it is associated with adverse cardiovascular and kidney outcomes. There are still many challenges and questions to address to improve the currently available therapeutic strategies to treat hyperkalemia, such as how to approach the emergency management of hyperkalemia. In recent years, in addition to novel oral potassium binders, great progress has been made in the application of novel kidney protective strategies, such as mineralocorticoid receptor antagonists and sodium–glucose cotransporter 2 inhibitors (SGLT2i) in hyperkalemia therapy. This review will discuss the recent advances from clinical trials in the effective management of hyperkalemia in non-dialysis CKD patients, enhancing the knowledge of physicians and internists concerning these newer agents and providing a helpful reference for clinical practice.

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Section: Recommendations Of Treatment For Hyperkalemiamentioning

confidence: 99%

Recent Progresses in Non-Dialysis Chronic Kidney Disease Patients with Hyperkalemia: Outcomes and Therapeutic Strategies

Tian

Zhou

2023

Medicina

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“…[42][43][44] Previously sodium polystyrene sulfonate (SPSS) was used to treat hyperkalemia but was not highly effective, it often was given with an osmotic laxative, which had occasional adverse effects on the gut. 45 The newer agents are more effective, better tolerated (even in long-term use) and have been shown to be able to help control serum potassium levels between dialysis therapies. 46,47 For example, Patiromer exchanges Ca ++ for K + , and SZC exchanges mostly H + but also some Na + for K + .…”

Section: Dialysate-regeneration and Oral Sorbents To Leverage "Freedo...mentioning

confidence: 99%

“…Oral potassium binders have been improved significantly with the market introduction of patiromer and sodium zirconium cyclosilicate (SZC) 42–44 . Previously sodium polystyrene sulfonate (SPSS) was used to treat hyperkalemia but was not highly effective, it often was given with an osmotic laxative, which had occasional adverse effects on the gut 45 . The newer agents are more effective, better tolerated (even in long‐term use) and have been shown to be able to help control serum potassium levels between dialysis therapies 46,47 .…”

Section: Issues With Current Krt Approachesmentioning

confidence: 99%

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

et al. 2022

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Background: Chronic kidney disease (CKD) is a major cause of early death worldwide. By 2030, 14.5 million people will have end-stage kidney disease (ESKD, or CKD stage 5), yet only 5.4 million will receive kidney replacement therapy (KRT) due to economic, social, and political factors. Even for those who are offered KRT by various means of dialysis, the life expectancy remains far too low.Observation: Researchers from different fields of artificial organs collaborate to overcome the challenges of creating products such as Wearable and/or Implantable Artificial Kidneys capable of providing long-term effective physiologic kidney functions such as removal of uremic toxins, electrolyte homeostasis, and fluid regulation. A focus should be to develop easily accessible, safe, and inexpensive KRT options that enable a good quality of life and will also be available for patients in less-developed regions of the world.Conclusions: Hence, it is required to discuss some of the limits and burdens of transplantation and different techniques of dialysis, including those performed at home. Furthermore, hurdles must be considered and overcome to develop wearable and implantable artificial kidney devices that can help to improve the quality of life and life expectancy of patients with CKD.

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“…Nevertheless, SPS has demonstrated adverse serious side effects [ 40 ]. Case reports have reported gastrointestinal injuries such as colitis and necrosis; however, a recent analysis in the literature by Holleck et al [ 40 ] did not find significantly higher rates in intestinal necrosis, although the composite outcome of severe gastrointestinal adverse events was significantly increased. The FDA has provided a warning about the use of sorbitol in concomitance with SPS as it can increase the risk for gastrointestinal necrotic events [ 31 , 32 ].…”

Section: Treatment Of Hyperkalemia: Advances In Therapiesmentioning

confidence: 99%

“…The overall burden of adverse side effects related to the use of new potassium binders seems to not significantly impact on the current administration of SZC and patiromer in patients with HK, and with HF in need for implementation of RAASi therapy in particular, as compared with the old-fashioned administration of SPS. Although the risk of necrosis seem to be not so higher as compared with controls, SPS still continues to show an increased risk for gastrointestinal side effects [ 40 ]. SZC mostly induces oedema as a major side effect, while hypokalemia event rates may vary according to the dosages and the baseline serum K + levels; no significant adverse gastrointestinal events have been identified in the different studies [ 64 ].…”

Section: Current Indication and Future Perspectivesmentioning

confidence: 99%

Optimizing Therapies in Heart Failure: The Role of Potassium Binders

Scicchitano¹,

Iacoviello

Massari³

et al. 2022

Biomedicines

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Heart failure (HF) is a worrisome cardiac pandemic with a negative prognostic impact on the overall survival of individuals. International guidelines recommend up-titration of standardized therapies in order to reduce symptoms, hospitalization rates, and cardiac death. Hyperkalemia (HK) has been identified in 3–18% of HF patients from randomized controlled trials and over 25% of HF patients in the “real world” setting. Pharmacological treatments and/or cardio-renal syndrome, as well as chronic kidney disease may be responsible for HK in HF patients. These conditions can prevent the upgrade of pharmacological treatments, thus, negatively impacting on the overall prognosis of patients. Potassium binders may be the best option in patients with HK in order to reduce serum concentrations of K+ and to promote correct upgrades of therapies. In addition to the well-established use of sodium polystyrene sulfonate (SPS), two novel drugs have been recently introduced: sodium zirconium cyclosilicate (SZC) and patiromer. SZC and patiromer are gaining a central role for the treatment of chronic HK. SZC has been shown to reduce K+ levels within 48 h, with guaranteed maintenance of normokalemia for up to12 months. Patiromer has resulted in a statistically significant decrease in serum potassium for up to 52 weeks. Therefore, long-term results seemed to positively promote the implementation of these compounds in clinical practice due to their low rate side effects. The aim of this narrative review is to delineate the impact of new potassium binders in the treatment of patients with HF by providing a critical reappraisal for daily application of novel therapies for hyperkalemia in the HF setting.

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Risk of Intestinal Necrosis With Sodium Polystyrene Sulfonate: A Systematic Review and Meta‐analysis

Cited by 10 publications

References 30 publications

Recent Progresses in Non-Dialysis Chronic Kidney Disease Patients with Hyperkalemia: Outcomes and Therapeutic Strategies

Recent Progresses in Non-Dialysis Chronic Kidney Disease Patients with Hyperkalemia: Outcomes and Therapeutic Strategies

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

Optimizing Therapies in Heart Failure: The Role of Potassium Binders

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