Kayexalate (sodium polystyrene sulfonate) is an ion exchange resin used in the treatment of hyperkalemia. It is associated with a number of adverse effects, primarily in the gastrointestinal trract.
Gastrointestinal toxicity of kayexalate:
(1) ischemic necrosis
(2) esophageal ulcerations
(3) ulcerations of the colon and/or rectum, which can perforate
(4) gastric ulcers and/or hemorrhagic gastritis
(5) duodenal ulcerations
(6) ileal ulcerations, which can perforate
Additional toxicities:
(1) pulmonary (if aspirated)
(2) reaction to sorbitol in fructose intolerance
Identification of crystals at the site of injury supports the diagnosis.
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