Efficacy and safety of calcium polystyrene sulfonate in patients with hyperkalemia and stage 3–5 non-dialysis chronic kidney disease: a single-center randomized controlled trial

Objective To observe the clinical efficacy and safety of the short-term administration of different doses of calcium polystyrene sulfonate in the treatment of hyperkalemia in patients with stage 3–5 non-dialysis chronic kidney disease. Methods A prospective, open, randomized, controlled, single-center clinical observation was conducted. In total, 107 patients were randomly assigned to receive calcium polystyrene sulfonate at 15 (group A) or 30 mg/day (group B) for 1 week. Patients were assessed on days 0, 3, and 7. Results After 3 days of treatment, the serum potassium levels in groups A and B had decreased by 0.68 ± 0.46 and 0.75 ± 0.43 mmol/L, respectively. After 7 days, the serum potassium levels in groups A and B had decreased by 0.64 ± 0.37 and 0.94 ± 0.49 mmol/L, respectively. Conversely, serum sodium, phosphorus, and calcium levels did not significantly change during the treatment period. Constipation was the most common adverse drug reaction, and no treatment-related serious adverse events were observed. Conclusion Calcium polystyrene sulfonate administered at a dose of 15 or 30 g/day can rapidly reduce potassium levels in patients with stage 3–5 non-dialysis chronic kidney disease without adverse effects on sodium, phosphorus, or calcium levels.