Georgianos PI, et al. - This study assessed long-term tolerability and efficacy of sodium polystyrene sulfonate (SPS) for the treatment of mild chronic hyperkalemia in chronic kidney disease (CKD). Findings demonstrated good tolerability as well as the efficacy of low-dose SPS in normalizing elevated serum potassium over several weeks in CKD outpatients with mild chronic hyperkalemia.

Methods

• This retrospective, observational study included a total of 26 outpatients with stages 3–4 CKD who received oral therapy with low-dose SPS for mild chronic hyperkalemia in the Outpatient Nephrology clinic of the Department during 2010–2016.
• Medical records were obtained on side effects potentially ascribed to SPS use, and the changes in serum electrolytes before and after the initiation of SPS therapy were assessed.

Results

• Findings demonstrated a fall in serum potassium levels from 5.9 ± 0.4 to 4.8 ± 0.5 mmol/l (P < 0.001) over a median follow-up of 15.4 months (range 3–27 months).
• Researchers observed that SPS use was associated with a slight, but significant elevation in serum sodium levels (139.5 ± 2.9 vs 141.2 ± 2.4, P = 0.006), whereas no change was visible in the serum calcium and phosphate before and after the initiation of SPS.
• Overall, ten episodes of recurrent serum potassium elevation ≥ 5.5 mmol/l were documented, none of which needed hospitalization or acute dialysis.
• Researchers did not observe any episode of colonic necrosis or any other serious drug-related adverse event.
• In addition, data reported good tolerability of SPS therapy, since only 1 out of 26 patients discontinued SPS at 3 months due to gastrointestinal intolerance.