RESINAS TROCADORAS DE CÁTIONS NA HIPERCALEMIA AGUDA GRAVE
Resumo
As resinas trocadoras de cátions fazem parte da abordagem terapêutica tradicional da hipercalemia. As resinas de troca catiônica são substâncias sintéticas, não absorvíveis, que liberam um cátion que faz parte de sua composição e captam outro cátion de interesse, no caso, o potássio, causando a redução da calemia. As resinas disponíveis atualmente são: poliestireno sulfonato de sódio (PSS), nos Estados Unidos, e poliestireno sulfonato de cálcio (PSC), no Brasil. Grande parte da literatura encontrada sobre estas resinas é proveniente de países onde é utilizado o PSS, cuja sua estrutura química e efeitos são similares aos do PSC.
Porém, como as resinas atualmente disponíveis são efetivas a partir de 24 horas de uso, não atendem à demanda pela remoção rápida de potássio, como ocorre na hipercalemia aguda com toxicidade cardíaca e manifestações eletrocardiográficas. Além disto, apesar de não serem absorvidas, as resinas não são substâncias inócuas, e podem causar complicações graves no aparelho digestivo.
Decisões sobre o uso das resinas na hipercalemia aguda grave devem ser feitas com cautela e considerando o contexto de cada paciente. O objetivo desta revisão é trazer mais dados que permitam ao leitor uma visão crítica sobre o papel real destas substâncias no tratamento da hipercalemia aguda.
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DOI: http://dx.doi.org/10.5380/rmu.v1i3.40751
DOI (PDF): http://dx.doi.org/10.5380/rmu.v1i3.40751.g24949
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