Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report

Abstract Background Sodium polystyrene sulfonate (SPS) is a cation-exchange resin used to treat hyperkalemia. Although colorectal ulcers are known side effects of long-term SPS use, few studies have reported SPS-associated gastric ulcers. Herein, we report a case of repeated gastric ulcers during SP...

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Main Authors: Yukiko Yasui, Akio Nakashima, Kosuke Sasuga, Kentaro Koike, Izumi Yamamoto, Yoshimi Ueda, Goro Tokudome, Ichiro Ohkido, Takashi Yokoo
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-024-03890-7
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author Yukiko Yasui
Akio Nakashima
Kosuke Sasuga
Kentaro Koike
Izumi Yamamoto
Yoshimi Ueda
Goro Tokudome
Ichiro Ohkido
Takashi Yokoo
author_facet Yukiko Yasui
Akio Nakashima
Kosuke Sasuga
Kentaro Koike
Izumi Yamamoto
Yoshimi Ueda
Goro Tokudome
Ichiro Ohkido
Takashi Yokoo
author_sort Yukiko Yasui
collection DOAJ
description Abstract Background Sodium polystyrene sulfonate (SPS) is a cation-exchange resin used to treat hyperkalemia. Although colorectal ulcers are known side effects of long-term SPS use, few studies have reported SPS-associated gastric ulcers. Herein, we report a case of repeated gastric ulcers during SPS administration. Case presentation The patient was a 55-year-old man who was on SPS treatment of hyperkalemia since the initiation of hemodialysis (HD) at the age of 51 years. At the age of 54 years, he started taking vonoprazan fumarate after developing a bleeding duodenal ulcer. The patient underwent laparoscopic pylorus-preserving gastrectomy for four recurrent bleeding gastric ulcers. The resected specimen showed an ulcerative lesion in the pyloric curvature of the stomach, and pathological findings showed deposition of a basophilic crystalline substance resembling a cation-exchange resin at the base of the ulcer. Conclusion In this case, various factors, including diabetic gastroenteropathy, use of multiple calcium channel blockers and phosphate binders, obesity, and lifestyle, contributed to decreased gastrointestinal peristalsis. This may have promoted SPS deposition in the stomach, potentially leading to ulceration.
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spelling doaj-art-bbbcfaade3024780b4cb0c978cf338bd2025-08-20T02:20:42ZengBMCBMC Nephrology1471-23692024-12-012511510.1186/s12882-024-03890-7Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case reportYukiko Yasui0Akio Nakashima1Kosuke Sasuga2Kentaro Koike3Izumi Yamamoto4Yoshimi Ueda5Goro Tokudome6Ichiro Ohkido7Takashi Yokoo8Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDepartment of Pathology, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of MedicineAbstract Background Sodium polystyrene sulfonate (SPS) is a cation-exchange resin used to treat hyperkalemia. Although colorectal ulcers are known side effects of long-term SPS use, few studies have reported SPS-associated gastric ulcers. Herein, we report a case of repeated gastric ulcers during SPS administration. Case presentation The patient was a 55-year-old man who was on SPS treatment of hyperkalemia since the initiation of hemodialysis (HD) at the age of 51 years. At the age of 54 years, he started taking vonoprazan fumarate after developing a bleeding duodenal ulcer. The patient underwent laparoscopic pylorus-preserving gastrectomy for four recurrent bleeding gastric ulcers. The resected specimen showed an ulcerative lesion in the pyloric curvature of the stomach, and pathological findings showed deposition of a basophilic crystalline substance resembling a cation-exchange resin at the base of the ulcer. Conclusion In this case, various factors, including diabetic gastroenteropathy, use of multiple calcium channel blockers and phosphate binders, obesity, and lifestyle, contributed to decreased gastrointestinal peristalsis. This may have promoted SPS deposition in the stomach, potentially leading to ulceration.https://doi.org/10.1186/s12882-024-03890-7HemodialysisSodium polystyrene sulfonateUlcerHyperkalemia
spellingShingle Yukiko Yasui
Akio Nakashima
Kosuke Sasuga
Kentaro Koike
Izumi Yamamoto
Yoshimi Ueda
Goro Tokudome
Ichiro Ohkido
Takashi Yokoo
Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
BMC Nephrology
Hemodialysis
Sodium polystyrene sulfonate
Ulcer
Hyperkalemia
title Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
title_full Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
title_fullStr Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
title_full_unstemmed Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
title_short Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report
title_sort sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis a case report
topic Hemodialysis
Sodium polystyrene sulfonate
Ulcer
Hyperkalemia
url https://doi.org/10.1186/s12882-024-03890-7
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