Rochester General Hospital and University of Rochester School of Medicine and Dentistry, Rochester, New York 14621, USA.
J Am Soc Nephrol. 2010 May;21(5):733-5. doi: 10.1681/ASN.2010010079. Epub 2010 Feb 18.
Sodium polystyrene sulfonate (SPS), an ion-exchange resin designed to bind potassium in the colon, was approved in 1958 as a treatment for hyperkalemia by the US Food and Drug Administration, 4 years before drug manufacturers were required to prove the effectiveness and safety of their drugs. In September 2009, citing reports of colonic necrosis, the Food and Drug Administration issued a warning advising against concomitant administration of sorbitol, an osmotic cathartic used to prevent SPS-induced fecal impaction and to speed delivery of resin to the colon, with the powdered resin; however, a premixed suspension of SPS in sorbitol, the only preparation stocked by many hospital pharmacies, is prescribed routinely for treatment of hyperkalemia. We can find no convincing evidence that SPS increases fecal potassium losses in experimental animals or humans and no evidence that adding sorbitol to the resin increases its effectiveness as a treatment for hyperkalemia. There is growing concern, however, that suspensions of SPS in sorbitol can be harmful. It would be wise to exhaust other alternatives for managing hyperkalemia before turning to these largely unproven and potentially harmful therapies.
聚苯乙烯磺酸鈉（SPS）是一种设计用于在结肠中结合钾的离子交换树脂，于 1958 年由美国食品和药物管理局（FDA）批准用于治疗高钾血症，这比药品制造商被要求证明其药物的有效性和安全性早了 4 年。2009 年 9 月，FDA 以结肠坏死报告为由发布警告，建议避免同时使用山梨醇，山梨醇是一种用于防止 SPS 引起的粪便嵌塞并加速树脂输送到结肠的渗透型泻药，与粉状树脂一起使用；然而，许多医院药房库存的只有 SPS 与山梨醇预混合的混悬剂，常被开处方用于治疗高钾血症。我们找不到令人信服的证据表明 SPS 会增加实验动物或人类粪便中钾的丢失，也没有证据表明向树脂中添加山梨醇会增加其治疗高钾血症的效果。然而，人们越来越担心，山梨醇中的 SPS 混悬剂可能有害。在转向这些基本未经证实且可能有害的治疗方法之前，明智的做法是先尝试其他治疗高钾血症的替代方法。
