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Potassium binders are medications that bind potassium ions in the gastrointestinal tract, thereby preventing its intestinal absorption. This category formerly consisted solely of polystyrene sulfonate, a polyanionic resin attached to a cation, administered either orally or by retention enema to patients who are at risk of developing hyperkalaemia (abnormal high serum potassium levels).
Common side effects include loss of appetite, gastrointestinal upset, constipation, and low blood calcium. [1] These polymers are derived from polystyrene by the addition of sulfonate functional groups. Sodium polystyrene sulfonate was approved for medical use in the United States in 1958. [1]
Measures to remove potassium from the body include diuretics such as furosemide, potassium-binders such as polystyrene sulfonate (Kayexalate) and sodium zirconium cyclosilicate, and hemodialysis. [1] Hemodialysis is the most effective method. [3] Hyperkalemia is rare among those who are otherwise healthy. [6]
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Several approaches are used to treat hyperkalemia. [12] Other approved potassium binders in the United States include patiromer and sodium polystyrene sulfonate. [13] Hyperkalemia, particularly if severe, is a marker for an increased risk of death. [14] However, there is disagreement regarding whether a modestly elevated levels directly causes ...
Definitive treatment of hyperkalemia requires actual excretion of potassium, either through urine (which can be facilitated by administration of loop diuretics such as furosemide) or in the stool (which is accomplished by giving sodium polystyrene sulfonate enterally, where it will bind potassium in the GI tract.)
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