2.1 = | 1.762 Cit. to date |
842 Docs. to date |
Updated monthly
Renato De Vecchis, Andrea Paccone
2021-01-19
Views: 937
HTML: 74
PDF: 408
|
Case description: A 64-year-old patient with chronic renal failure and persistent hyperkalaemia not corrected by dialysis, was prescribed sodium polystyrene sulfonate (SPS) at a low dose (30 g/day for 2 days a week during the long interdialytic interval). After 3 months of therapy, the patient developed intense abdominal pain with non-specific colitis identified with a colonoscopy. In addition, the biopsy specimens showed rhomboid SPS crystals in the intestinal mucosa. Fourteen months after discontinuing therapy, the patient again presented with colitis and persistent biopsy finding of SPS crystals. The patient died a few months later due to intestinal infarction.
Discussion and conclusion: SPS is a cation exchange resin used to treat hyperkalaemia resistant to dialysis, but may cause inflammation and ischaemia of the colon. In our patient, a short 3-month course of low-dose SPS therapy (without sorbitol, which is used to counter iatrogenic constipation caused by SPS) induced relapsing colitis, which was followed by massive intestinal infarction a few months later. In light of frequent reports of its enterotoxic effects, SPS should be replaced with the new potassium chelators (patiromer and sodium zirconium cyclosilicate).
2.1 = | 1.762 Cit. to date |
842 Docs. to date |
Official Journal of the
European Federation of Internal Medicine
www.efim.org
Publisher: SMC media Srl
Via Giovenale, 7 - 20136 Milan - Italy
P.IVA 07626490960
info@ejcrim.com
www.ejcrim.com - ISSN: 2284-2594 - © EFIM 2014-2024, Published by SMC Media srl, Italy - Privacy policy