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Management of mild hyperkalemia with sodium polystyrene sulfonate: is it necessary?

F Yousaf, B Spinowitz, C Charytan

Aim: There is no consensus defining clinically significant hyperkalemia or settings which require potassium (K+) lowering therapy. We explored the management of mild hyperkalemia, defined as a serum K+ ≤5.6 mEq/l, when treated with sodium polystyrene sulfonate (SPS).

Materials & methods: Medical records of patients ≥18 years, who had received SPS for serum K+ ≤5.6 mEq/l, were reviewed.

Results: A total of 106 SPS doses were given to 92 patients for a serum K+ ≤5.6 mEq/l. Significant delays between the pre-SPS serum K+ and SPS administration and between SPS administration and followup serum K+ were evident.

Conclusion: Mild elevations in potassium, which may not be clinically significant, are often treated with SPS while its therapeutic monitoring remains inadequate.