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Wednesday, May 20, 2020

SZC for hyperkalemia

PulmCrit (EMCrit)
PulmCrit - May 20, 2020 - By Josh Farkas
"Summary: The Bullet
  • Sodium Zirconium Cyclosilicate (SZC) is an oral potassium binder, essentially an upgrade of sodium polystyrene sulfonate (Kayexalate). Unlike sodium polystyrene sulfonate, SZC doesn’t appear to cause bowel necrosis.
  • SZC is studied predominantly for subacute to chronic reduction in potassium. However, it does appear to cause some reduction in potassium levels acutely (perhaps ~0.2 mM within 4 hours, and ~0.4 mM within 24 hours).
  • The role of SZC for acute management of hyperkalemia is currently unclear. SZC appears to be safe, but it’s debatable whether it is effective enough to cause meaningful patient-centered benefit. SZC may be considered as an adjunctive therapy for the management of moderate hyperkalemia, but it must be used with recognition of its minimal efficacy.
  • SZC may help put the nails in the coffin of sodium polystyrene sulfonate (Kayexalate). Specifically, if there are any residual situations where sodium polystyrene sulfonate may be considered or recommended, these patients can be treated more safely and effectively with SZC."