The major controversy in the management of potassium disorders lies in the usage of SPS for the treatment of emergent hyperkalemia. SPS was designed when dialysis was still in its infancy and physicians had few options for treatment. The original study conducted by Scherr et al was the first to use a binding substance in an attempt to lower serum potassium.56 In the study, 32 patients with renal failure were enrolled to receive SPS and a low-calorie diet. At the conclusion of the study, 30 patients had a decrease or no increase in serum potassium and 23 patients had a mean fall of potassium of at least 0.4 mEq/L.56
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