Efficacy and safety of calcium polystyrene sulfonate in patients with hyperkalemia and stage 3-5 non-dialysis chronic kidney disease: a single-center randomized controlled trial

J Int Med Res. 2023 Apr;51(4):3000605231167516. doi: 10.1177/03000605231167516.

Abstract

Objective: To observe the clinical efficacy and safety of the short-term administration of different doses of calcium polystyrene sulfonate in the treatment of hyperkalemia in patients with stage 3-5 non-dialysis chronic kidney disease.

Methods: A prospective, open, randomized, controlled, single-center clinical observation was conducted. In total, 107 patients were randomly assigned to receive calcium polystyrene sulfonate at 15 (group A) or 30 mg/day (group B) for 1 week. Patients were assessed on days 0, 3, and 7.

Results: After 3 days of treatment, the serum potassium levels in groups A and B had decreased by 0.68 ± 0.46 and 0.75 ± 0.43 mmol/L, respectively. After 7 days, the serum potassium levels in groups A and B had decreased by 0.64 ± 0.37 and 0.94 ± 0.49 mmol/L, respectively. Conversely, serum sodium, phosphorus, and calcium levels did not significantly change during the treatment period. Constipation was the most common adverse drug reaction, and no treatment-related serious adverse events were observed.

Conclusion: Calcium polystyrene sulfonate administered at a dose of 15 or 30 g/day can rapidly reduce potassium levels in patients with stage 3-5 non-dialysis chronic kidney disease without adverse effects on sodium, phosphorus, or calcium levels.

Keywords: Hyperkalemia; calcium; calcium polystyrene sulfonate; chronic kidney disease; phosphorus; potassium; sodium.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Calcium
  • Humans
  • Hyperkalemia* / drug therapy
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / drug therapy
  • Phosphorus
  • Potassium
  • Prospective Studies
  • Sodium

Substances

  • polystyrene sulfonic acid
  • Calcium
  • Potassium
  • Sodium
  • Phosphorus