| Gastrointestinal Adverse Events with Sodium Polystyrene Sulfonate (Kayexalate) Use: A Systematic Review. | |
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MedLine Citation:
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PMID: 23321430 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Sodium polystyrene sulfonate (Kayexalate; Sanofi-Aventis, Paris, France) is a cation-exchange resin routinely used in the management of hyperkalemia. However, its use has been associated with colonic necrosis and other fatal gastrointestinal adverse events. Although the addition of sorbitol to sodium polystyrene sulfonate preparations was previously believed to be the cause of gastrointestinal injury, recent reports have suggested that sodium polystyrene sulfonate itself may be toxic. Our objective was to systematically review case reports of adverse gastrointestinal events associated with sodium polystyrene sulfonate use. METHODS: MEDLINE (1948 to July 2011), EMBASE (1980 to July 2011), Cochrane Central Register of Controlled Trials (CENTRAL) (1993 to July 27, 2011), bibliographies of identified articles, and websites of relevant drug agencies and professional associations in the United States and Canada were reviewed to identify eligible reports of adverse gastrointestinal events associated with sodium polystyrene sulfonate use. Causality criteria of the World Health Organization causality assessment system were applied to each report. RESULTS: Thirty reports describing 58 cases (41 preparations containing sorbitol and 17 preparations without sorbitol) of adverse events were identified. The colon was the most common site of injury (n=44; 76%), and transmural necrosis (n=36; 62%) was the most common histopathologic lesion reported. Mortality was reported in 33% of these cases due to gastrointestinal injury. CONCLUSIONS: Sodium polystyrene sulfonate use, both with and without sorbitol, may be associated with fatal gastrointestinal injury. Physicians must be cognizant of the risk of these adverse events when prescribing this therapy for the management of hyperkalemia. |
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Authors:
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Ziv Harel; Shai Harel; Prakesh S Shah; Ron Wald; Jeffrey Perl; Chaim M Bell |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-12 |
Journal Detail:
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Title: The American journal of medicine Volume: - ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Nephrology, St Michael's Hospital, University of Toronto, Ontario, Canada; Department of Medicine and Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Ontario, Canada. Electronic address: harelz@smh.ca. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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