Wu Yi-Hua, Chou Jen-Wei, Lai Hsiang-Chun, Su Gin-Shen, Cheng Ken-Sheng, Chen Tsung-Wei
Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
School of Medicine, China Medical University Hospital, Taichung, Taiwan.
Clin Exp Gastroenterol. 2021 Jan 11;14:1-18. doi: 10.2147/CEG.S278812. eCollection 2021.
Patients with hyperkalemia are commonly treated with Kayexalate or Kalimate. Both drugs are associated with some fatal gastrointestinal (GI) adverse events (AEs).
To assess the clinical characteristics and outcomes of GI AEs induced by Kayexalate or Kalimate from published case reports.
We conducted a systematic review of case reports of Kayexalate or Kalimate-induced GI AEs, from PubMed, Medline, Cochrane Library, Clinical Key, and Google Scholar databases (1948 to March 31, 2020). We analyzed the clinical characteristics, GI AEs, and risk factors of enrolled patients.
We identified 41 published articles describing 135 cases of GI AEs induced by Kayexalate (103 cases) or Kalimate (32 cases). The mean age of all patients was 55.5 years. Most patients were male (54.8%). As high as 55.6% preparations were administered with sorbitol whereas 44.4% preparations had no sorbitol. The average time causing GI AEs was 19.8 days. Colon was the most commonly affected site (76.3%). Drug crystals were histopathologically proven in 95.5% of the patients. Meanwhile, mortality was reported in 20.7%.
Kayexalate or Kalimate, without or with sorbitol combination, may be related to fatal GI damage. Uremia, hypertension, and transplantation are predisposing factors. Clinicians should be careful in prescribing Kayexalate or Kalimate to patients.
高钾血症患者通常使用聚苯乙烯磺酸钠或聚磺苯乙烯钙进行治疗。这两种药物都与一些致命的胃肠道不良事件相关。
通过已发表的病例报告评估聚苯乙烯磺酸钠或聚磺苯乙烯钙引起的胃肠道不良事件的临床特征和结局。
我们对来自PubMed、Medline、Cochrane图书馆、Clinical Key和谷歌学术数据库（1948年至2020年3月31日）的聚苯乙烯磺酸钠或聚磺苯乙烯钙引起的胃肠道不良事件的病例报告进行了系统评价。我们分析了纳入患者的临床特征、胃肠道不良事件和危险因素。
我们确定了41篇已发表的文章，描述了135例由聚苯乙烯磺酸钠（103例）或聚磺苯乙烯钙（32例）引起的胃肠道不良事件。所有患者的平均年龄为55.5岁。大多数患者为男性（54.8%）。高达55.6%的制剂与山梨醇一起使用，而44.4%的制剂不含山梨醇。引起胃肠道不良事件的平均时间为19.8天。结肠是最常受影响的部位（76.3%）。95.5%的患者经组织病理学证实有药物结晶。同时，报告的死亡率为20.7%。
聚苯乙烯磺酸钠或聚磺苯乙烯钙，无论是否与山梨醇联合使用，都可能与致命的胃肠道损伤有关。尿毒症、高血压和移植是易感因素。临床医生在给患者开聚苯乙烯磺酸钠或聚磺苯乙烯钙时应谨慎。
