Sodium polystyrene sulfate (Kayexalate, Sanofi-Aventis, Bridgewater, NJ) is a cation-exchange resin, used for treating hyperkalemia, with its pharmacologic action primarily based in the colon. Because Kayexalate can crystallize and even cause impaction, it is often administered with an osmotic laxative, usually sorbitol. Kayexalate-associated small-bowel and colon ulceration and/or necrosis are well known. However, only a few cases of upper GI tract injury after oral administration have been reported.
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