Society of Diabetic Nephropathy Prevention Journal of Nephropharmacology 2345-4202 16 1 2027 01 01 Efficacy and safety of polystyrene sulfonates for the treatment of hyperkalaemia in hospitalised adult patients; a scoping review e12816 e12816 10.34172/npj.12816 EN Mogamat-Yazied Chothia https://orcid.org/0000-0002-9801-1300 Ntombizodwa Mpungose https://orcid.org/0009-0004-1775-1297 Journal Article 10.34172/npj.12816 2025 09 22 2026 07 10 Sodium and calcium polystyrene sulfonate (SPS and CPS) are potassium-binding resins frequently prescribed in the management of hyperkalaemia. We conducted a scoping review to examine the efficacy and safety of polystyrene sulfonates in hospitalised adults with hyperkalaemia and to identify knowledge gaps relevant to clinical practice. This scoping review was conducted following the PRISMA-ScR guidelines. Studies were eligible for inclusion if they reported on the use of SPS or CPS in hospitalised adults for the treatment of hyperkalaemia. Searches were conducted on Medline (PubMed) and the Web of Science Core Collection. The protocol was prospectively registered with the Open Science Framework. In this study, seventeen studies were included, representing 31 treatment arms and 4325 hospitalised adult patients. Overall, the mean baseline serum potassium concentration was 5.8 ± 0.28 mmol/L, with a mean reduction of approximately 1.0 mmol/L. No significant difference was observed between SPS and CPS (0.98 mmol/L versus 0.95 mmol/L; P = 0.829). The median time to nadir serum potassium was 12.5 hours. A moderate negative correlation was observed between polystyrene sulfonate dose and the change in serum potassium concentration (r = -0.462, P = 0.010). SPS dose was significantly correlated with potassium reduction (r = -0.457, P = 0.019), while CPS was not (r=-0.515, P = 0.485). Constipation was the most common gastrointestinal adverse event, occurring most frequently in patients who received CPS. Hypernatraemia, hypocalcaemia and hypoglycaemia were observed only in SPS-treated patients, whereas hypercalcaemia occurred exclusively in those treated with CPS. In this study, we concluded that polystyrene sulfonates showed a modest reduction in serum potassium concentrations in patients who had mild hyperkalaemia regardless of resin type. While gastrointestinal and metabolic adverse events were uncommon, the specific side effects varied according to the type of resin used.