ArticleClinical kidney journal2023
Sodium polystyrene is unsafe and should not be prescribed for the treatment of hyperkalaemia:
Article in Clinical kidney journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- [Consensus recommendations on the diagnosis and treatment of hyperkalemia of the Austrian Society of Nephrology 2026].Wiener klinische Wochenschrift · 2026Review
- Article
- What to do with key cardiovascular drugs when kidney function worsens?Clinical kidney journal · 2026Review
- Sodium Polystyrene Sulfonate and Heart Failure Risk: A Comparative Study With Calcium Polystyrene Sulfonate.Nephrology (Carlton, Vic.) · 2025Article
- Aldosterone-targeted therapies: early implementation in resistant hypertension and chronic kidney disease.European heart journal · 2025Review
- Sodium zirconium cyclosilicate for MRAs optimization in HFrEF: lessons learned from the REALIZE-K trial.Heart failure reviews · 2025Review
- EMCREG-International Multidisciplinary Consensus Panel on Management of Hyperkalemia in Chronic Kidney Disease and Heart Failure.Cardiorenal medicine · 2025Review
- Management of hyperkalemia: Expert consensus from Kuwait - a Modified Delphi Approach.International journal of nephrology and renovascular disease · 2024Article
- Sodium polystyrene is unsafe and should not be prescribed for the treatment of hyperkalaemia:Clinical kidney journal · 2023Article
- Safety and efficacy of novel potassium binders for chronic hyperkalemia: a systematic review and meta-analysis of randomized controlled trials.Proceedings (Baylor University. Medical Center)Review
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2 authors.
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Abstract
'Old-generation' potassium (K) binders [i.e. sodium (SPS) and calcium polystyrene sulfonate] are widely used, but with substantial heterogeneity across countries to treat hyperkalaemia (HK). However, there are no randomized data to support their chronic use to manage HK, nor have they been shown to have a renin-angiotensin-aldosterone system inhibitor (RAASi)-enabling effect. These compounds have poor tolerability and an unpredictable onset of action and magnitude of K lowering. Furthermore, SPS may induce fluid overload, owing to the fact that it exchanges K for sodium. Its use has also been associated with colonic necrosis, as emphasized by a black box warning from the US Food and Drug Administration. In contrast, two new K binders, patiromer and sodium zirconium cyclosilicate, have been shown to be safe and well tolerated for chronic management of HK, thereby enabling RAASi optimization, as acknowledged by the latest international cardiorenal guidelines. In view of the lack of reliable evidence regarding the efficacy and safety of the old-generation K binders compared with the placebo-controlled randomized and real-word evidence demonstrating the safety, efficacy and RAASi-enabling effect of the new K binders, clinicians should now use these new K binders to treat HK (
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