Two Cases of Sigmoid Colon Perforation Induced by Calcium Polystyrene Sulfonate in Chronic Renal Failure Patients

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  • ポリスチレンスルホン酸カルシウム内服中の慢性腎不全患者に発症したS状結腸穿孔の2例

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Abstract

<p>Calcium polystyrene sulfonate (CPS) is a cation exchange resin used for treating hyperkalemia in renal failure patients. This drug causes hard stool and constipation. As a serious side effect, intestinal tract perforation has been reported. We experienced two cases of sigmoid colon perforation in chronic renal failure patients who were taking CPS. Case 1 was an 88-year-old woman receiving hemodialysis, and Case 2 was a 73-year-old woman with chronic renal failure before introducing dialysis. In both cases, surgical intervention elucidated sigmoid perforation near the mesenteric side. Pathological diagnosis revealed CPS crystals accumulated around the intestinal wall of these perforation sites. In chronic renal failure patients, the intestinal wall is vulnerable due to chronic blood flow disturbance caused by uremia and arterial sclerosis. So, the risk of intestinal tract perforation is high due to increased intestinal pressure. Therefore, it is suggested that appropriate defecation control from the start of CPS intake is important for such patients.</p>

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