The following is a summary of “Sodium polystyrene sulfonate versus sodium zirconium cyclosilicate for the treatment of hyperkalemia in the emergency department,” published in the March 2023 issue of Emergency Medicine by Hasara, et al.

In the United States, approximately 800,000 people attend emergency rooms (ED) owing to hyperkalemia each year, and it has been linked to considerable morbidity & death, presumably because of deadly cardiac dysrhythmias. When potassium levels in the ED were stabilized, mortality decreased in prior research. To eliminate potassium from the body, cation exchange resins such as sodium polystyrene sulfonate (SPS) and sodium zirconium cyclosilicate (SZC) may be supplied. The procedure is dictated by a doctor’s preference and not supported by reliable facts. Within two hours of delivery, serum potassium levels were reduced in two investigations comparing cation exchange resins in the ED to standard care; however, no research comparing these treatments head-to-head had been published. For a study, researchers aimed to compare SPS and SZC for reducing serum potassium in individuals who presented to the emergency department (ED) with hyperkalemia.

The retrospective cohort study was carried out at a single ED and received approval from the institutional review board. The inclusion criteria included patients who got medicine under the “ED Hyperkalemia Therapy” order between August 26, 2019, and May 13, 2021. The main result was the difference in serum potassium levels between the baseline and the first repetition level after SPS or SZC treatment in the ED.

The final analyses included 54 patients from the SPS group and 51 patients from the SZC group out of 885 patients who underwent screening. Following the delivery of the cation exchange resin, the mean change in serum potassium from the initial level to the first repeat level was -1.1 mEq/L for both groups.

Similar drops in serum potassium were attained by administering SPS or SZC to treat hyperkalemia in the emergency department.

Reference: sciencedirect.com/science/article/pii/S0735675722007860