2021 Volume 41 Issue 7 Pages 537-541
Calcium polystyrene sulfonate（CPS）is a cation exchange resin that is used for treating hyperkalemia in patients with renal failure. This drug causes hard stools and constipation. As a serious side effect, intestinal tract perforation has also been reported. We report two cases of patients with chronic kidney disease（CKD）under maintenance hemodialysis who developed CPS-induced sigmoid colon perforation. Case 1 was an 88-year-old woman, and Case 2 was a 76-year-old man; both had CKD and were undergoing maintenance hemodialysis. In both cases, surgical exploration revealed sigmoid colon perforation near the mesenteric side. Histopathological examination of the resected specimen revealed accumulation of CPS crystals in the intestinal wall around the perforation site in both cases. In CKD patients, as the intestinal wall is already vulnerable due to chronic blood flow disturbance caused by uremia and arterial sclerosis, the risk of intestinal perforation associated with increase of the intestinal pressure is high in these patients. Therefore, appropriate measures for defecation control is important in patients with CKD started on treatment with CPS.
