Effects of sodium polystyrene sulfonate: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major research findings

Sodium polystyrene sulfonate (PSS) is a medication commonly used to treat hyperkalemia. 23 found that administering PSS to lower the potassium concentration in milk delayed the introduction of peritoneal dialysis in a 1-month-old infant with milk allergy. 18 reviewed the efficacy and safety of PSS in treating patients with chronic kidney disease (CKD) and hyperkalemia. 2 conducted a systematic review and meta-analysis to evaluate the association between PSS usage and the risk of intestinal necrosis. 5 reported the potential digestive complications associated with PSS in dialysis patients. 4 investigated the effect of PSS on reducing potassium content in food. examined the clinical effects and side reactions of PSS in treating hyperkalemia associated with renal insufficiency. 17 conducted a case study to understand the influence of salts and sugars on the interaction between bovine serum albumin and PSS. 6 explored the antiplaque effect of PSS in a clinical study. 15 compared a single dose of SZC (Sodium zirconium cyclosilicate) with PSS in hospitalized patients with hyperkalemia. 25 discussed the mechanism, clinical significance, and management of hyperkalemia induced by RAAS (Renin-angiotensin-aldosterone system) inhibitors. 8 assessed the efficacy of single-dose SZC compared to PSS in managing asymptomatic hyperkalemia in hospitalized patients. 20 evaluated the effectiveness and safety of potassium-lowering regimens, including PSS, in treating acute hyperkalemia in hemodialysis patients. 21 conducted an in vitro evaluation of a pH-sensitive hydrogel for controlled drug delivery using PSS. 16 compared the efficacy of patiromer and PSS in reducing potassium levels in chronic hemodialysis patients. 1 compared the effects of calcium and sodium polystyrene sulfonate on mineral and bone metabolism in patients with hyperkalemia. 10 evaluated the efficacy of orally administered montmorillonite in a rat model of myoglobinuric acute renal failure. 24 presented a unique case report of gastric pneumatosis as a rare side effect of PSS. 7 examined the effect of PSS treatment on serum potassium concentrations in mice with lithium toxicity. 12 compared SZC to PSS for the inpatient management of acute hyperkalemia. 11 compared the effectiveness and safety of PSS and SZC for hyperkalemia treatment in hospitalized patients. 1 compared the effects of calcium and PSS on mineral and bone metabolism in patients with hyperkalemia. 19 discussed the role of potassium binders, including PSS, in optimizing therapies for heart failure. 9 reviewed strategies for understanding and treating hypertension and hyperkalemia in CKD patients. 14 reviewed potassium disorders, including hypokalemia and hyperkalemia.

Benefits and Risks

Benefit Summary

PSS has been shown to be effective in treating hyperkalemia. 23 found that administering PSS to lower the potassium concentration in milk delayed the introduction of peritoneal dialysis in a 1-month-old infant with milk allergy. 18 reviewed the efficacy and safety of PSS in treating patients with chronic kidney disease (CKD) and hyperkalemia. 25 discussed the mechanism, clinical significance, and management of hyperkalemia induced by RAAS (Renin-angiotensin-aldosterone system) inhibitors. 19 discussed the role of potassium binders, including PSS, in optimizing therapies for heart failure. 9 reviewed strategies for understanding and treating hypertension and hyperkalemia in CKD patients.

Risk Summary

PSS has the potential to cause gastrointestinal side effects. 2 conducted a systematic review and meta-analysis to evaluate the association between PSS usage and the risk of intestinal necrosis. 5 reported the potential digestive complications associated with PSS in dialysis patients. 24 presented a unique case report of gastric pneumatosis as a rare side effect of PSS.

Comparison of Studies

Commonalities among Studies

Many studies have demonstrated the effectiveness of PSS in treating hyperkalemia. They also consistently mention the possibility of gastrointestinal side effects.

Differences among Studies

There are variations in the efficacy and severity of side effects reported in different studies. 23 found that administering PSS to lower the potassium concentration in milk delayed the introduction of peritoneal dialysis in a 1-month-old infant with milk allergy. 18 reviewed the efficacy and safety of PSS in treating patients with chronic kidney disease (CKD) and hyperkalemia. 25 discussed the mechanism, clinical significance, and management of hyperkalemia induced by RAAS (Renin-angiotensin-aldosterone system) inhibitors. 19 discussed the role of potassium binders, including PSS, in optimizing therapies for heart failure. 9 reviewed strategies for understanding and treating hypertension and hyperkalemia in CKD patients.

Consistency and Discrepancies in Results

Several studies consistently indicate that PSS is effective in treating hyperkalemia. However, the possibility of gastrointestinal side effects is also consistently mentioned, and the extent of these effects varies across studies.

Considerations for Real-Life Applications

PSS is an effective medication for treating hyperkalemia, but it's crucial to use it under the guidance of a healthcare professional due to the potential for gastrointestinal side effects. Additionally, individuals with hyperkalemia should be mindful of their diet and seek dietary guidance as PSS can reduce the amount of potassium in food.

Limitations of Current Research

Despite extensive research on PSS, further investigation is still necessary. Specifically, further research is required to understand the mechanisms underlying PSS-induced gastrointestinal side effects and explore ways to mitigate these side effects.

Future Directions for Research

Future research on PSS should focus on more detailed analysis of its efficacy and safety. Furthermore, elucidating the mechanisms behind PSS-induced gastrointestinal side effects and developing strategies to minimize these side effects are crucial.

Conclusion

PSS is an effective medication for treating hyperkalemia, but it's crucial to use it under the guidance of a healthcare professional due to the potential for gastrointestinal side effects. Further research is needed to improve our understanding of PSS's efficacy and safety. It's important to consult with your healthcare provider if you have hyperkalemia to determine the best course of treatment for your individual needs.

Literature analysis of 25 papers
Positive Content
20
Neutral Content
0
Negative Content
5
Article Type
3
2
2
5
24
1.

Compared effects of calcium and sodium polystyrene sulfonate on mineral and bone metabolism and volume overload in pre-dialysis patients with hyperkalemia.

Author: NakayamaYosuke, UedaKaoru, YamagishiSho-Ichi, SugiyamaMiki, YoshidaChika, KurokawaYuka, NakamuraNao, MoriyamaTomofumi, KodamaGoh, MinezakiTomohisa, ItoSakuya, NagataAkiko, TaguchiKensei, YanoJunko, KaidaYusuke, ShibatomiKazutaka, FukamiKei

Hyperkalemia treatment
Bone metabolism
Mineral metabolism

Hyperkalemia is a prevalent and dangerous condition in end-stage renal disease patients, often leading to life-threatening arrhythmias. While polystyrene sulfonate (PS) is widely used for treatment, the direct comparison of effects between calcium PS (CPS) and sodium PS (SPS) on mineral and bone metabolism has not been explored.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

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

Author: HolleckJürgen L, RobertsAndrea E, MarhofferElizabeth A, GrimshawAlyssa A, GundersonCraig G

Intestinal necrosis

This systematic review examines the gastrointestinal side effects of sodium polystyrene sulfonate (SPS), particularly intestinal necrosis. The review included studies with controls and reported the rates of intestinal necrosis associated with SPS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Compared effects of calcium and sodium polystyrene sulfonate on mineral and bone metabolism and volume overload in pre-dialysis patients with hyperkalemia.

Author: NakayamaYosuke, UedaKaoru, YamagishiSho-Ichi, SugiyamaMiki, YoshidaChika, KurokawaYuka, NakamuraNao, MoriyamaTomofumi, KodamaGoh, MinezakiTomohisa, ItoSakuya, NagataAkiko, TaguchiKensei, YanoJunko, KaidaYusuke, ShibatomiKazutaka, FukamiKei

Hyperkalemia treatment
Bone metabolism
Mineral metabolism

Hyperkalemia is a prevalent and dangerous condition in end-stage renal disease patients, often leading to life-threatening arrhythmias. While polystyrene sulfonate (PS) is widely used for treatment, the direct comparison of effects between calcium PS (CPS) and sodium PS (SPS) on mineral and bone metabolism has not been explored.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

[Digestive adverse effects due to sodium polystyrene sulfonate (Kayexalate) in dialysis patients].

Author: MontagnacRichard, MéhautSylvie, SchillingerFrancis

Hyperkalemia reduction
Intestinal damage

Sodium polystyrene sulfonate, a medication used to reduce hyperkalemia, can cause digestive complications, including intestinal necrosis or perforation.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

6.

Effects of sodium polystyrene sulfonate on gingival plaque: microbiological investigation and clinical follow-up.

Author: AronnaG, De RosaA, TorinoM, MartiniS, SangesM R, EspositoT, CatalanottiP

Reduced bacteria
Reduced plaque index

Topical application of sodium polystyrene sulfonate reduced plaque index, total bacteria, and Gram-negative bacteria in a small group of subjects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Sodium polystyrene sulfonate treatment for lithium toxicity: effects on serum potassium concentrations.

Author: LinakisJ G, HullK M, LacoutureP G, LockhartG R, LewanderW J, MaherT J

Hypokalemia

Sodium polystyrene sulfonate (SPS) treatment significantly reduced serum potassium (K) concentrations in mice, especially when combined with lithium (Li) pretreatment. This suggests a potential limitation in the use of SPS for lithium toxicity.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Efficacy of orally administered montmorillonite in myoglobinuric acute renal failure model in male rats.

Author: Hoseini AzadSeyed Ali, MoshiriMohammad, RoohbakhshAli, ShakeriAbolfazl, Fatemi ShandizAshkan, EtemadLeila

Improved kidney function
Unknown

Montmorillonite, a clay with strong cation exchange capacity, effectively reduced the levels of urea, creatinine, potassium, and calcium in rats with acute kidney injury.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

A randomized study to compare oral potassium binders in the treatment of acute hyperkalemia.

Author: CañasAlejandro E, TrouttHayden R, JiangLuohua, TonthatSam, DarwishOmar, FerreyAntoney, LotfipourShahram, Kalantar-ZadehKamyar, HannaRamy, LauWei Ling

Potassium binder
Hyperkalemia

This study aims to compare the effectiveness of oral potassium binders versus a nonspecific laxative in the treatment of acute hyperkalemia. The study will investigate the change in potassium levels, length of hospital stay, and gastrointestinal side effects.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Comparative efficacy of patiromer and sodium polystyrene sulfonate on potassium levels in chronic haemodialysis patients: a randomized crossover trial.

Author: JaquesDavid A, StuckerFabien, ErnandezThomas, AlvesCyrielle, MartinPierre-Yves, De SeigneuxSophie, SaudanPatrick

Cardiovascular mortality
Hyperkalemia

Patiromer and sodium polystyrene sulfonate (SPS) are both potassium binders used to treat hyperkalemia in patients with end stage renal disease. A study found that patiromer was more effective than SPS in lowering potassium levels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Biomolecular Complexation on the "Wrong Side": A Case Study of the Influence of Salts and Sugars on the Interactions between Bovine Serum Albumin and Sodium Polystyrene Sulfonate.

Author: SimončičMatjaž, HritzJozef, LukšičMiha

This study investigated the interactions between bovine serum albumin (BSA) and sodium polystyrene sulfonate (NaPSS) at pH 8.0, exploring the modulatory effects of salts (NaCl, NaBr, and NaI) and sugars (sucrose and sucralose). The results suggest that electrostatic interactions, modulated by the ionic strength and type of anion, are the main driving force for complexation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Efficacy and safety of potassium binders in the treatment of patients with chronic kidney disease and hyperkalemia.

Author: DongLingqiu, XuWeidong, DengYi, TanJiaxing, QinWei

Hyperkalemia treatment

Sodium polystyrene sulfonate (SPS), calcium polystyrene sulfonate (CPS), patiromer, and sodium zirconium cyclosilicate (SZC) are drugs that are used to treat high potassium levels in people with chronic kidney disease. The best option for patients is unclear.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Optimizing Therapies in Heart Failure: The Role of Potassium Binders.

Author: ScicchitanoPietro, IacovielloMassimo, MassariFrancesco, De PaloMicaela, CaldarolaPasquale, MannariniAntonia, PassantinoAndrea, CicconeMarco Matteo, MagnesaMichele

HF treatment
Side effects of potassium binders

This narrative review discusses the impact of new potassium binders, sodium zirconium cyclosilicate (SZC) and patiromer, in the treatment of heart failure (HF) patients with hyperkalemia (HK). SZC and patiromer have shown efficacy in reducing serum potassium levels, promoting the correct upgrade of therapies, and having low side effect rates.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Effects of different potassium-lowering regimens on acute hyperkalemia in hemodialysis patients: a real-world, retrospective study.

Author: YaoLan, XingXiaoyang, LiYubao, ZhangFangxing, LiPing, LiangXianhui, WangPei

Convenient treatment
Potassium lowering
Reduced side effects
Decreased calcium
Decreased magnesium
Hypoglycemia

Sodium zirconium cyclosilicate (SZC) effectively reduces serum potassium levels in maintenance hemodialysis (MHD) patients with acute hyperkalemia, with comparable efficacy to insulin and glucose (IG) intravenous administration but superior convenience and fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

A case of 1-month-old female infant delaying peritoneal dialysis introduction by low-potassium anti-allergic formula treated with sodium polystyrene sulfonate.

Author: IidaTakaya, NishimuraTatsuya, MizukoshiYoko, TsuruokaTomoko, HisanoMasataka

Delayed dialysis
Potassium control
Milk allergy

This case report describes a young infant with severe kidney problems who was unable to tolerate a specialized milk formula due to a milk allergy. The doctors successfully managed the infant's potassium levels using a low-potassium anti-allergic formula and sodium polystyrene sulfonate.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Sodium Polystyrene Sulfonate-Induced Gastric Pneumatosis: A Rare Side Effect.

Author: DasuNeethi, KhalidYaser, DasuKirti, JooLucy, BlairBrian

gastric pneumatosis

This case report describes a unique case of gastric pneumatosis as a complication of kayexalate.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

25.

Hyperkalemia with RAAS inhibition: Mechanism, clinical significance, and management.

Author: HundemerGregory L, SoodManish M

Continued RAAS inhibitor use
Hyperkalemia mitigation
Cardiovascular events
Hyperkalemia

This article discusses the management of hyperkalemia, a common adverse effect of renin-angiotensin-aldosterone system (RAAS) inhibitors. The article highlights the challenge of balancing the risks and benefits of RAAS inhibitors, and discusses the role of modern pharmacologic agents, such as patiromer and zirconium cyclosilicate, in mitigating hyperkalemia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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