{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:15:03Z","timestamp":1762049703005,"version":"build-2065373602"},"reference-count":9,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Potassium binders are essential tools to treat hyperkalemia, particularly in patients with heart failure and chronic kidney disease. One of the drug-related complications is constipation, which further worsens heart failure by increasing afterload and decreases patients\u2019 quality of life. We encountered an 82-year-old man with heart failure, chronic kidney disease, and hyperkalemia. A conventional potassium binder, calcium polystyrene sulfonate, ameliorated his hyperkalemia, whereas he became aware of refractory constipation. A conversion to a newly-introduced specific potassium binder, sodium zirconium cyclosilicate, improved persistent constipation, maintaining serum potassium levels within a normal range. Sodium zirconium cyclosilicate might be a preferable potassium binder to treat hyperkalemia, particularly in patients with heart failure and chronic kidney disease and those suffering from constipation.<\/jats:p>","DOI":"10.3390\/medicina58050635","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T08:26:35Z","timestamp":1651566395000},"page":"635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Successful Conversion from Conventional Potassium Binder to Sodium Zirconium Cyclosilicate in a Patient with Refractory Constipation"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-7637","authenticated-orcid":false,"given":"Teruhiko","family":"Imamura","sequence":"first","affiliation":[{"name":"The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Kinugawa","sequence":"additional","affiliation":[{"name":"The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/j.jacc.2016.06.060","article-title":"Hyperkalemia in Heart Failure","volume":"68","author":"Sarwar","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"264.e9","DOI":"10.1016\/j.amjmed.2012.08.016","article-title":"Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: A systematic review","volume":"126","author":"Harel","year":"2013","journal-title":"Am. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s40265-018-0991-6","article-title":"Sodium Zirconium Cyclosilicate: A Review in Hyperkalaemia","volume":"78","author":"Hoy","year":"2018","journal-title":"Drugs"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Stavros, F., Yang, A., Leon, A., Nuttall, M., and Rasmussen, H.S. (2014). Characterization of structure and function of ZS-9, a K+ selective ion trap. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0114686"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_6","first-page":"54","article-title":"Efficacy and safety of sodium zirconium cyclosilicate for hyperkalaemia: The randomized, placebo-controlled HARMONIZE-Global study","volume":"7","author":"Zannad","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Imamura, T., Oshima, A., Narang, N., and Kinugawa, K. (2021). Clinical Implications of Sodium Zirconium Cyclosilicate Therapy in Patients with Systolic Heart Failure and Hyperkalemia. J. Clin. Med., 10.","DOI":"10.3390\/jcm10235523"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1002\/clc.23683","article-title":"Management of hyperkalemia in chronic heart failure using sodium zirconium cyclosilicate","volume":"44","author":"Oshima","year":"2021","journal-title":"Clin. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/jch.13489","article-title":"Constipation-induced pressor effects as triggers for cardiovascular events","volume":"21","author":"Ishiyama","year":"2019","journal-title":"J. Clin. Hypertens"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/635\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:05:34Z","timestamp":1760137534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,3]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["medicina58050635"],"URL":"https:\/\/doi.org\/10.3390\/medicina58050635","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2022,5,3]]}}}