Abstract
Standard treatment of hyperkalemia has consisted of the administration of a number of medications including sodium polystyrene sulfonate (SPS) suspension orally or as an enema. Dosage ranges of 15 to 60 g are described in the literature, but specific dosing recommendations based on a patient's serum potassium are lacking. The purpose of this study was to develop a dosing guideline for the oral administration of SPS in the treatment of adult hyperkalemia at our institution.
A retrospective review was conducted for adult patients receiving only SPS to treat hyperkalemia during a 3-month period. Serum levels of potassium were recorded prior to and following SPS administration. The retrospective review demonstrated that a 30 g SPS dose resulted in an average decrease in serum potassium of 0.99 mEq/L with a standard deviation (SD) of 0.64. Based on these results, an SPS dose of 30 g was recommended for a serum potassium level greater than 5 mEq/L but less than 6.0 mEq/L in the guidelines. A SPS dose of 60 g was recommended for a serum potassium level of 6 mEq/L or greater. After an internal review in the pharmacy and physician approval, the guidelines were instituted. Clinical outcomes were monitored for 1 month following implementation of the guideline. The prospective analysis resulted in an average decrease of 1.01 mEq/L (SD = 0.67) in serum potassium with a 30 g SPS dose, supporting the guideline.
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