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Thursday, May 21, 2015

Can Sodium Polystyrene Sulfonate be administered for as long as a month?


  • a study followed 14 chronic kidney disease (CKD) patients without haemodialysis (HD). These patients had hyperkalaemia induced by renin-angiotensin-aldosterone system inhibition (RAAS-I) and were being treated with low dose (15g OD) Sodium Polystyrene Sulfonate (SPS) from 2005 till 2010 (14.5 months).
  • They were found to have no episodes of hyperkalaemia while there were on the therapy. In addition to that, they were well tolerant without the need for withdrawal or reduction of RAAS-I therapy. 
  • Hence it was safely concluded by the study that low dose SPS would be of benefit.


  • In addition to the study above, other resources fail to show if it should or should not be recommended. However one thing all the studies did agree on were that routine check on patient's electrolyte levels were crucial. Patient should also be educated on symptoms of hypokalaemia to avoid any complications.

Signs of hypokalaemia
  • Irritability, confusion, and delayed thought process
  • Muscle weakness, hyporeflexia, and eventually paralysis.
  • Apnoea may be a serious consequence of this progression.
  • Electrocardiographic changes showing hypokalaemia or hypercalaemia may cause cardiac arrhythmia and doctors should be alerted about this complications at start of such long term therapy.
References:
  1. http://onlinelibrary.wiley.com/doi/10.1002/clc.20987/pdf
  2. http://products.sanofi.ca/en/resonium-calcium.pdf
  3. http://www.rch.org.au/clinicalguide/guideline_index/Hyperkalaemia/


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