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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).
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]
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 ...
Sodium polystyrene sulfonate is used as a superplastifier in cement, as a dye improving agent for cotton, and as proton exchange membranes in fuel cell applications. In its acid form, the resin is used as a solid acid catalyst in organic synthesis , [ 16 ] mostly commonly under the tradename Amberlyst.
Aldosterone binds to aldosterone receptors (mineralocorticoid receptors) increasing sodium reabsorption in an effort to increase blood pressure and improve fluid status in the body. When excessive sodium reabsorption occurs, there is an increasing loss of K + in the urine and can lead to clinically significant decreases, termed hypokalemia ...
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Patiromer was generally well tolerated in studies. Side effects that occurred in more than 2% of patients included in clinical trials were mainly gastro-intestinal problems such as constipation, diarrhea, nausea, and flatulence, and also hypomagnesemia (low levels of magnesium in the blood) in 5% of patients, because patiromer binds magnesium in the gut as well.
Mild hyperkalemia without symptoms can be treated with a loop diuretic and sodium polystyrene sulfonate, while a temporizing agent such as rapid acting insulin (in conjunction with glucose) and an agent to stabilize cardiac membranes such as calcium carbonate may be given in cases of severe hyperkalemia. [18]