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. 2020 May;70(5):270-279.
doi: 10.1111/pin.12906. Epub 2020 Jan 30.

Intestinal necrosis related to administration of cation exchange resin without sorbitol: A retrospective analysis of 61 patients with end-stage renal diseases

Keigo Murakami  1 , Yasuhiro Nakamura  2 , Yasunori Miyasaka  3 , Toshinobu Sato  3 , Naoki Kawagishi  4 , Hironobu Sasano  1
Affiliations

Intestinal necrosis related to administration of cation exchange resin without sorbitol: A retrospective analysis of 61 patients with end-stage renal diseases

Keigo Murakami et al. Pathol Int. 2020 May.

Abstract

Intestinal necrosis associated with cation exchange resin (CER) is considered related to sorbitol, but it has been reported even in patients receiving CER alone. This study was performed to identify the risk factors of CER-related intestinal necrosis. The pathological database of 61 end-stage renal disease patients with surgical intervention for intestinal perforation was reviewed. The correlations between CER treatment and clinicopathological factors were studied among three groups: (i) patients administered CER and with CER at the perforation site (n = 23), (ii) patients administered CER with undetected CER at the perforation site (n = 12) and (iii) patients not administered CER (n = 26). The majority of the perforation site in group 1 was in the sigmoid colon (82.6%) with significantly higher average age and more frequent CER adhesion rates to the mucosa around the perforation site than group 2. The laxative administration rate in group 1 was significantly higher than group 3 and tended to be higher than group 2. The incidence of CER-related intestinal necrosis was estimated at 0.57%. CER should be used with extreme caution in elderly patients with passage disturbance.

Keywords: calcium polystyrene sulfonate (Kalimate); cation exchange resin; end-stage renal disease; intestinal necrosis; sodium polystyrene sulfonate (Kayexalate).

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References

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