Intestinal necrosis due to sodium polystyrene sulfonate (Kayexalate) in sorbitol

Southern Medical Journal

Volumn 102, Issue 5, 2009, Pages 493-497

  McGowan, C E ^a   Saha, S ^b   Chu, G ^b   Resnick, M B ^b   Moss, S F ^b  

^a RHODE ISLAND HOSPITAL   (United States)

^b NONE

Author keywords

Cation exchange resins; Hyperkalemia; Ischemic colitis; Kidney failure

Indexed keywords

POLYSTYRENESULFONATE SODIUM; POTASSIUM; SORBITOL; CATION EXCHANGE RESIN; LAXATIVE; POLYSTYRENE DERIVATIVE; POLYSTYRENESULFONIC ACID;

ABDOMINAL DISTENSION; ABDOMINAL PAIN; ADULT; AGED; ARTICLE; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL ARTICLE; COLON ISCHEMIA; COMORBIDITY; CORONARY ARTERY DISEASE; DIABETES MELLITUS; DISEASE COURSE; DRUG IDENTIFICATION; FEMALE; GASTROINTESTINAL HEMORRHAGE; GASTROINTESTINAL MUCOSA; HISTOPATHOLOGY; HUMAN; HUMAN TISSUE; HYPERKALEMIA; HYPERLIPIDEMIA; HYPERTENSION; INTESTINE INJURY; INTESTINE ISCHEMIA; INTESTINE NECROSIS; INTESTINE ULCER; KIDNEY FAILURE; MALE; MEDICAL RECORD REVIEW; MORTALITY; OUTCOME ASSESSMENT; POSTOPERATIVE PERIOD; POTASSIUM BLOOD LEVEL; RETROSPECTIVE STUDY; UREMIA; CHEMICALLY INDUCED DISORDER; CHRONIC KIDNEY FAILURE; COHORT ANALYSIS; INTESTINE MUCOSA; ISCHEMIA; MIDDLE AGED; NECROSIS; PATHOLOGY; VASCULARIZATION;

ADULT; AGED; AGED, 80 AND OVER; CATHARTICS; CATION EXCHANGE RESINS; COHORT STUDIES; FEMALE; HUMANS; HYPERKALEMIA; INTESTINAL MUCOSA; ISCHEMIA; KIDNEY FAILURE, CHRONIC; MALE; MIDDLE AGED; NECROSIS; POLYSTYRENES; RETROSPECTIVE STUDIES; SORBITOL;

EID: 65649108915     PISSN: 00384348     EISSN: None     Source Type: Journal    
DOI: 10.1097/SMJ.0b013e31819e8978     Document Type: Article

References (30)

1. Dardik A, Moesinger RC, Efron G, et al. Acute abdomen with colonic necrosis induced by Kayexalate-sorbitol. South Med J 2000;93:511-513. (Pubitemid 30366235)
2. Abraham SC, Bhagavan BS, Lee LA, et al. Upper gastrointestinal tract injury in patients receiving kayexalate (sodium polystyrene sulfonate) in sorbitol: clinical, endoscopic, and histopathologic findings. Am J Surg Pathol 2001;25:637-644.
3. Gerstman BB, Kirkman R, Platt R. Intestinal necrosis associated with postoperative orally administered sodium polystyrene sulfonate in sorbitol. Am J Kidney Dis 1992;20:159-161.
4. Lillemoe KD, Romolo JL, Hamilton SR, et al. Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery 1987;101:267-272.
5. Scott TR, Graham SM, Schweitzer EJ, et al. Colonic necrosis following sodium polystyrene sulfonate (Kayexalate)-sorbitol enema in a renal transplant patient. Report of a case and review of the literature. Dis Colon Rectum 1993;36:607-609.
6. Wootton FT, Rhodes DF, Lee WM, et al. Colonic necrosis with Kayexalate- sorbitol enemas after renal transplantation. Ann Intern Med 1989;111:947-949.
7. Rashid A, Hamilton SR. Necrosis of the gastrointestinal tract in uremic patients as a result of sodium polystyrene sulfonate (Kayexalate) in sorbitol: an underrecognized condition. Am J Surg Pathol 1997;21:60-69. (Pubitemid 27026606)
8. Kelsey PB, Chen S, Lauwers GY. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 37-2003. A 79-year-old man with coronary artery disease, peripheral vascular disease, end-stage renal disease, and abdominal pain and distention. N Engl J Med 2003;349:2147-2155.
9. Rogers FB, Li SC. Acute colonic necrosis associated with sodium polystyrene sulfonate (Kayexalate) enemas in a critically ill patient: case report and review of the literature. J Trauma 2001;51:395-397.
10. Cheng ES, Stringer KM, Pegg SP. Colonic necrosis and perforation following oral sodium polystyrene sulfonate (Resonium A/Kayexalate) in a burn patient. Burns 2002;28:189-190.
11. Chatelain D, Brevet M, Manaouil D, et al. Rectal stenosis caused by foreign body reaction to sodium polystyrene sulfonate crystals (Kayexalate). Ann Diagn Pathol 2007;11:217-219. (Pubitemid 46694371)
12. Shioya T, Yoshino M, Ogata M, et al. Successful treatment of a colonic ulcer penetrating the urinary bladder caused by the administration of calcium polystyrene sulfonate and sorbitol. J Nippon Med Sch 2007;74:359-363. (Pubitemid 47523080)
13. Roy-Chaudhury P, Meisels IS, Freedman S, et al. Combined gastric and ileocecal toxicity (serpiginous ulcers) after oral kayexalate in sorbital therapy. Am J Kidney Dis 1997;30:120-122. (Pubitemid 27284384)
14. Bennett LN, Myers TF, Lambert GH. Cecal perforation associated with sodium polystyrene sulfonate-sorbitol enemas in a 650 gram infant with hyperkalemia. Am J Perinatol 1996;13:167-170.
15. Parfitt JR, Driman DK. Pathological effects of drugs on the gastrointestinal tract: a review. Hum Pathol 2007;38:527-536. (Pubitemid 46399901)
16. Price AB, Davies DR. Pseudomembranous colitis. J Clin Pathol 1977;30:1-12.
17. Mitsudo S, Brandt LJ. Pathology of intestinal ischemia. Surg Clin North Am 1992;72:43-63.
18. Kabaroudis A, Papaziogas B, Koutelidakis I, et al. Disruption of the small intestinal mucosal barrier after intestinal occlusion: a study with light and electron microscopy. J Invest Surg 2003;16:23-28. (Pubitemid 36372581)
19. Brewster DC, Franklin DP, Cambria RP, et al. Intestinal ischemia complicating abdominal aortic surgery. Surgery 1991;109:447-454.
20. Arvanitakis C, Malek G, Uehling D, et al. Colonic complications after renal transplantation. Gastroenterology 1973;64:533-538.
21. Berlyne GM, Janabi K, Shaw AB. Dangers of resonium A in the treatment of hyperkalemia in renal failure. Lancet 1966;1:167-169.
22. Flinn RB, Merrill JP, Welzant WR. Treatment of the oliguric patient with a new sodium-exchange resin and sorbitol. N Engl J Med 1961;264:111-115.
23. Scherr L, Ogden DA, Mead AW, et al. Management of hyperkalemia with a cation-exchange resin. N Engl J Med 1961;264:115-119.
24. Emmett M, Hootkins RE, Fine KD, et al. Effect of three laxatives and a cation exchange resin on fecal sodium and potassium excretion. Gastroenterology 1995;108:752-760.
25. Gruy-Kapral C, Emmett M, Santa Ana CA, et al. Effect of single dose resin-cathartic therapy on serum potassium concentration in patients with end-stage renal disease. J Am Soc Nephrol 1998;9:1924-1930. (Pubitemid 28443490)
26. Noerr B. Sodium polystyrene sulfonate (Kayexalate). Neonatal Netw 1993;12:77-79.
27. AMA Department of Drugs. AMA Drug Evaluations. Chicago, IL, American Medical Association, 1986, ed 6.
28. Ziessman HA. Alkalosis and seizure due to a cation exchange resin and magnesium hydroxide. South Med J 1976;69:497-499.
29. Zijlstra FJ. Sorbitol, prostaglandins, and ulcerative colitis enemas. Lancet 1981;2:815-816. (Pubitemid 11020357)
30. Johnson K, Gardner ME. Kayexalate candy. Am J Hosp Pharm 1978;35:1034-1035.