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Hyperkalemia in Renal Failure:  The Effectiveness of Treatment Depends on the Gastrointestinal Tract as a Locus of Exchange

Philip R. Steinmetz, M.D.; John E. Kiley, M.D.
JAMA. 1961;175(8):689-693. doi:10.1001/jama.1961.63040080001010.
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A HIGH potassium concentration in the extracellular fluid is a dangerous and often early complication of renal failure. It may require treatment long before other uremic manifestations become serious, especially if the renal failure is associated with a state of rapid catabolism.

Measures, such as correction of acidosis and administration of glucose-insulin mixtures, may promote a movement of potassium ions into the cells and lower the extracellular potassium concentration temporarily, but fail to remove any potassium from the body. Peritoneal lavage and hemodialysis remove potassium effectively, but these procedures are rather formidable for the removal of a single cation from the extracellular space. Various exchange resins with affinity for potassium allow binding and removal of potassium ions without loss of a great volume of gastrointestinal content.1-9

It is the purpose of this report to describe our experience with sodium polystyrene sulfonate in the treatment and prevention of hyperkalemia from

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