Clin Nephrol. 2024 Oct;102(4):223-231. doi: 10.5414/CN111226.
Hyperkalemia is a common complication of chronic kidney disease (CKD). This study aims to investigate the efficacy and safety of sodium zirconium cyclosilicate and calcium polystyrene sulfonate in reducing potassium in patients with acute and severe hyperkalemia in CKD who are not undergoing dialysis.
A retrospective real-world study was conducted among 73 patients with non-dialysis chronic kidney disease who were hospitalized in the First Affiliated Hospital of Chengdu Medical College from June 2020 to June 2022. 33 patients treated with sodium zirconium cyclosilicate were categorized as SZC group, and the other 40 patients treated with calcium polystyrene sulfonate were categorized as CPS group. Serum potassium, serum sodium, magnesium, calcium, and phosphorus levels were examined. Adverse reactions were recorded during medication.
Significantly decreased serum potassium was observed in both groups, whereas the potassium reduction was higher in the SZC group than in the CPS group at 2, 4, 24, and 48 hours after medication while there was no statistically significant difference in the serum potassium level between the two groups at 72 hours. For those people whose initial potassium exceeded 6 mmol/L, the potassium reduction was more obvious in the SZC group than in the CPS group at 2 and 4 hours after medication. The control rate of hyperkalemia in the SZC group was significantly higher than in the CPS group at 4, 24, and 48 hours. No distinct change was observed in serum sodium, calcium, magnesium, and phosphorus before and 72 hours after medication. No severe adverse reactions occurred.
Sodium zirconium cyclosilicate has a more obvious effect on reducing potassium particularly for those patients with moderate to severe hyperkalemia who need rapid potassium reduction.
高钾血症是慢性肾脏病（CKD）的常见并发症。本研究旨在探讨硅酸锆钠和聚苯乙烯磺酸钙在不透析的急性和严重 CKD 高钾血症患者中降低血钾的疗效和安全性。
回顾性真实世界研究纳入 2020 年 6 月至 2022 年 6 月在成都医学院第一附属医院住院的 73 例非透析慢性肾脏病患者。33 例接受硅酸锆钠治疗的患者分为 SZC 组，另 40 例接受聚苯乙烯磺酸钙治疗的患者分为 CPS 组。检测血清钾、血清钠、镁、钙和磷水平。记录用药期间的不良反应。
两组患者的血清钾均显著降低，SZC 组在用药后 2、4、24 和 48 小时的血钾降低幅度均高于 CPS 组，而两组在 72 小时的血钾水平无统计学差异。对于初始血钾超过 6mmol/L 的患者，SZC 组在用药后 2 和 4 小时的血钾降低幅度明显大于 CPS 组。SZC 组在用药后 4、24 和 48 小时的高钾血症控制率明显高于 CPS 组。用药前后血清钠、钙、镁、磷无明显变化。未发生严重不良反应。
硅酸锆钠在降低血钾方面的效果更为明显，特别是对于需要快速降低血钾的中重度高钾血症患者。
