Журнал клинических случаев

Acute Abdomen from Kayexalate Utilization

Abstract

Mehulkumar Joshi, Tu Tran Hyunh, Shotaro Sano and Jaime TE

Hyperkalemia in end stage renal disease patients is a common complication. Sodium polystyrene sulfonate (Kayexalate) is a commonly used in the treatment of hyperkalemia. This case report discusses about Kayexalateinduced colonic necrosis, a rare but fatal complication of this commonly used medication.

Keywords

Sodium polystyrene sulfonate; Kayexalate; Bowel; Necrosis; Acute abdomen

Introduction

Sodium polystyrene sulfonate (SPS, Kayexalate), has been used in management of hyperkalemia since 1957 when it was first discovered. Kayexalate is a cation resin used either as oral or as an enema form in the management of hyperkalemia. Originally sorbitol was mixed with sodium polystyrene sulfonate as a cathartic to avoid constipation. Even though kayexalate is used often to treat hyperkalemia, its side effect of colonic necrosis is a rare complication that was first discussed in 1987, in a series featuring five uremic patients. The study led to the FDA advisory to discontinue the addition of sorbitol due to this associated risk of colonic necrosis [1].