EFFICACY AND SAFETY OF POLYSTYRENE SULFONATES IN TREATMENT OF HYPERKALAEMIA IN HOSPITALISED ADULT PATIENTS: A SCOPING REVIEW

 

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https://storage.unitedwebnetwork.com/files/1099/26dfca1820d8d6e03f47598a6a9cada7.pdf
EFFICACY AND SAFETY OF POLYSTYRENE SULFONATES IN TREATMENT OF HYPERKALAEMIA IN HOSPITALISED ADULT PATIENTS: A SCOPING REVIEW

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Mogamat-Yazied
Chothia
Zodwa Mpungose zodwa310@yahoo.com Stellenbosch University Nephrology Cape Town South Africa -
Mogamat-Yazied Chothia yaziedc@sun.ac.za Stellenbosch University Nephrology Cape Town South Africa *
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Sodium and calcium polystyrene sulfonate (SPS and CPS) are potassium-binding resins frequently prescribed in the management of hyperkalaemia. We conducted a scoping review to examine the efficacy and safety of polystyrene sulfonates in hospitalised adults with hyperkalaemia and to identify knowledge gaps relevant to clinical practice.

This scoping review was conducted following the PRISMA-ScR guidelines. Studies were eligible for inclusion if they reported on the use of SPS or CPS in hospitalised adults for the treatment of hyperkalaemia. Searches were conducted on Medline (PubMed) and the Web of Science Core Collection. The protocol was prospectively registered with the Open Science Framework.

Correlation between polystyrene sulfonate (SPS and CPS) dose and the reduction in the serum potassium concentration. SPS, sodium polystyrene sulfonate; CPS, calcium polystyrene sulfonate; [K+], serum potassium concentration.Seventeen studies were included, representing 31 treatment arms and 4325 hospitalised adult patients. Overall, the mean baseline serum potassium concentration was 5.8 ± 0.28 mmol/L, with a mean reduction of approximately 1.0 mmol/L. No significant difference was observed between SPS and CPS (0.98 mmol/L vs. 0.95 mmol/L; p = 0.829). The median time to nadir serum potassium was 12.5 hours. A moderate negative correlation was observed between polystyrene sulfonate dose and the change in serum potassium concentration (r = -0.462, p = 0.010)(Figure). SPS dose was significantly correlated with potassium reduction (r = -0.457, p = 0.019), while CPS was not (r=-0.515; p = 0.485). Constipation was the most common gastrointestinal adverse event, occurring most frequently in patients who received CPS. Hypernatraemia, hypocalcaemia and hypoglycaemia were observed only in SPS-treated patients, whereas hypercalcaemia occurred exclusively in those treated with CPS.

Polystyrene sulfonates showed a modest reduction in serum potassium concentrations in patients who had mild hyperkalaemia regardless of resin type. While gastrointestinal and metabolic adverse events were uncommon, the specific side effects varied according to the type of resin used.

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