Lee Tae Yeong, Park Jong Kyu, Lee Sang Jin, Noh Byeong-Joo
Korean J Helicobacter Up Gastrointest Res. 2024 Sep;24(3):281-285. doi: 10.7704/kjhugr.2024.0036. Epub 2024 Sep 9.
Kalimate (calcium polystyrene sulfonate) is a cation-exchange resin commonly used in clinical practice to treat hyperkalemia. However, Kalimate has been demonstrated to also cause serious gastrointestinal injuries, such as colonic necrosis, ulcerations, and perforations, in a subset of patients with chronic renal failure; these cases have been reported with and without the administration of hypertonic sorbitol. These lesions usually occur in the large or small intestine; lesions occurring in the stomach are rarely reported. We present the case of a 62-year-old woman with very large Kalimate-induced gastric ulcers that were mistaken for advanced gastric cancer in patients with chronic renal failure who had been taking Kalimate for the previous 3 months. The patient was successfully treated by discontinuing Kalimate and initiating a proton pump inhibitor.
降钾树脂(聚苯乙烯磺酸钙)是临床实践中常用的一种阳离子交换树脂,用于治疗高钾血症。然而,在一部分慢性肾衰竭患者中,降钾树脂已被证明会导致严重的胃肠道损伤,如结肠坏死、溃疡和穿孔;无论是否给予高渗山梨醇,均有此类病例报道。这些病变通常发生在大肠或小肠;胃内出现病变的情况鲜有报道。我们报告了一例62岁女性患者的病例,该患者因服用降钾树脂3个月,出现了非常大的由降钾树脂引起的胃溃疡,在慢性肾衰竭患者中被误诊为进展期胃癌。通过停用降钾树脂并开始使用质子泵抑制剂,该患者得到了成功治疗。