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Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders
(1) Background: Constipation is one of the most serious adverse effects of potassium-lowering agents and decreases patients’ quality of life. Sodium zirconium cyclosilicate (SZC) is a recently innovated potassium binder intended for patients with hyperkalemia. The impact of SZC on the worsening of c...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531607/ https://www.ncbi.nlm.nih.gov/pubmed/37762911 http://dx.doi.org/10.3390/jcm12185971 |
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author | Hida, Yuki Imamura, Teruhiko Kinugawa, Koichiro |
author_facet | Hida, Yuki Imamura, Teruhiko Kinugawa, Koichiro |
author_sort | Hida, Yuki |
collection | PubMed |
description | (1) Background: Constipation is one of the most serious adverse effects of potassium-lowering agents and decreases patients’ quality of life. Sodium zirconium cyclosilicate (SZC) is a recently innovated potassium binder intended for patients with hyperkalemia. The impact of SZC on the worsening of constipation, as compared with conventional potassium binders, remains unknown. (2) Methods: Patients with hyperkalemia who continued SZC for over 3 months between July 2020 and May 2022 were included in this retrospective study. Patients who received other conventional potassium binders during the same period were included as a control group. Trends in the doses of anti-constipation agents during the 3-month therapeutic period were compared between the two groups as a surrogate for worsening constipation. (3) Results: A total of 50 patients (median age 74 years, 31 male) were included, consisting of 22 patients with SZC and 28 patients with other conventional potassium binders. All patients had hyperkalemia and chronic kidney disease at baseline. During the 3-month therapeutic period, serum potassium levels decreased significantly in both groups (p < 0.05 for both). The number of anti-constipation remained unchanged in the SZC group but tended to increase in the control group (p = 0.56 and p = 0.090, respectively). The total dose change in all anti-constipations was significantly lower in the SZC group than in the control group (p = 0.037). (4) Conclusions: Conventional potassium binders have a tendency to worsen constipation, whereas SZC may have the potential to improve hyperkalemia without worsening constipation. SZC may be recommended, particularly in elderly patients with ongoing or high-risk constipation. |
format | Online Article Text |
id | pubmed-10531607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-105316072023-09-28 Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders Hida, Yuki Imamura, Teruhiko Kinugawa, Koichiro J Clin Med Article (1) Background: Constipation is one of the most serious adverse effects of potassium-lowering agents and decreases patients’ quality of life. Sodium zirconium cyclosilicate (SZC) is a recently innovated potassium binder intended for patients with hyperkalemia. The impact of SZC on the worsening of constipation, as compared with conventional potassium binders, remains unknown. (2) Methods: Patients with hyperkalemia who continued SZC for over 3 months between July 2020 and May 2022 were included in this retrospective study. Patients who received other conventional potassium binders during the same period were included as a control group. Trends in the doses of anti-constipation agents during the 3-month therapeutic period were compared between the two groups as a surrogate for worsening constipation. (3) Results: A total of 50 patients (median age 74 years, 31 male) were included, consisting of 22 patients with SZC and 28 patients with other conventional potassium binders. All patients had hyperkalemia and chronic kidney disease at baseline. During the 3-month therapeutic period, serum potassium levels decreased significantly in both groups (p < 0.05 for both). The number of anti-constipation remained unchanged in the SZC group but tended to increase in the control group (p = 0.56 and p = 0.090, respectively). The total dose change in all anti-constipations was significantly lower in the SZC group than in the control group (p = 0.037). (4) Conclusions: Conventional potassium binders have a tendency to worsen constipation, whereas SZC may have the potential to improve hyperkalemia without worsening constipation. SZC may be recommended, particularly in elderly patients with ongoing or high-risk constipation. MDPI 2023-09-14 /pmc/articles/PMC10531607/ /pubmed/37762911 http://dx.doi.org/10.3390/jcm12185971 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hida, Yuki Imamura, Teruhiko Kinugawa, Koichiro Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title | Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title_full | Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title_fullStr | Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title_full_unstemmed | Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title_short | Constipation as a Drug-Related Adverse Effect in Patients with Hyperkalemia: Sodium Zirconium Cyclosilicate versus Conventional Potassium Binders |
title_sort | constipation as a drug-related adverse effect in patients with hyperkalemia: sodium zirconium cyclosilicate versus conventional potassium binders |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531607/ https://www.ncbi.nlm.nih.gov/pubmed/37762911 http://dx.doi.org/10.3390/jcm12185971 |
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