Volume 5, Issue 2, March 2017, Page: 28-33
Potassium Removal from Juices Using an Individual Single-Use Ion-Exchange Device
Alexander Pushkin, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Rachel Mund, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Anna Nadya Pushkin, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Allan Zevelev, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Debra Newman, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Ofelia Berina, Department of Pathology and Laboratory Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Maria Golchin, Department of Pathology and Laboratory Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Ira Kurtz, Department of Medicine, D. Geffen School of Medicine at UCLA, Los Angeles, USA
Received: Feb. 7, 2017;       Accepted: Feb. 28, 2017;       Published: Mar. 15, 2017
DOI: 10.11648/j.jfns.20170502.12      View  2059      Downloads  138
Abstract
There are more than 100 million patients with various stages of chronic kidney disease (CKD) with decrease in CKD1 to loss in CKD 5 (end stage renal disease, ESRD) in the ability of the kidney to excrete K+ causing hyperkalemia and potentially heart attack. To avoid hyperkalemia, kidney patients have to drastically limit the consumption of fruit and vegetable juices that significantly decreases the nutritional value of their diet. Previous research using ion-exchange column chromatography demonstrated some efficiency in the K+ removal from juices without pulp, whereas no approaches have been generated for the K+ removal from juices with pulp (e.g. the most popular in the USA orange juice). Currently there are no commercially available low K+ fruit/vegetable juices for renal patients nor do patients have the ability to lower the K+ in juices on an individual basis. A device is reported that individual patients can use to remove K+ from juices with or without pulp using permeable t-sacs with Dowex Monosphere 99/320 Ca cation-exchange resin. The device significantly lowers the K+ content (by ~80% of original), is simple to use, and will be of benefit to patients who are on K+ restricted diets.
Keywords
Diet, Potassium, Chronic Kidney Disease, Juice
To cite this article
Alexander Pushkin, Rachel Mund, Anna Nadya Pushkin, Allan Zevelev, Debra Newman, Ofelia Berina, Maria Golchin, Ira Kurtz, Potassium Removal from Juices Using an Individual Single-Use Ion-Exchange Device, Journal of Food and Nutrition Sciences. Vol. 5, No. 2, 2017, pp. 28-33. doi: 10.11648/j.jfns.20170502.12
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
ESRD Patients in 2012. A Global Perspective. (2013). http://www.vision-fmc.com/files/pdf_2/ESRD_Patients_2012.pdf.
[2]
World Kidney Day: Chronic Kidney Disease. (2015). http://www.worldkidneyday.org/faqs/chronic-kidney-disease/. Access: 06/06/2016.
[3]
Couser, W. G.; Remuzzi, G.; Mendis, S. and Tonelli, M. (2011). The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int., 80, 1258–1270.
[4]
Gekle, M. I. (2016). Kidney and aging - A narrative review. Exp. Gerontol., 2016 Mar 24. pii: S0531-5565(16)30081-X. doi: 10.1016/j.exger.2016.03.013. [Epub ahead of print].
[5]
Jha, V.; Garcia-Garcia, G.; Iseki, K.; Li, Z.; Naicker, S.; Plattner, B.; Saran, R.; Wang, A. Y-M. and Yang, C. W. (2013). Chronic kidney disease: global dimension and perspectives. Lancet, 382, 260–272.
[6]
Levey, A. S.; Atkins, R.; Coresh, J.; Cohen, E. P.; Collins, A. J.; Eckardt, K. U.; Nahas, M. E.; Jaber, B. L.; Jadoul, M.; Levin, A.; Powe, N. R.; Rossert, J.; Wheeler, D. C.; Lameire, N. and Eknoyan, G. (2007). Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int., 72, 247–259.
[7]
Kalantar-Zadeh, K.; Tortorici, A. R.; Chen, J. L.; Kamgar, M.; Lau, W. L.; Moradi, H.; Rhee, C. M.; Streja, E. and Kovesdy, C. P. (2015). Dietary restrictions in dialysis patients: is there anything left to eat? Semin. Dial., 28, 159–168.
[8]
Stern, R. H.; Grieff, M. and Bernstein, P. L. (2016). Treatment of hyperkalemia: something old, something new. Kidney Int., 89, 546–554.
[9]
Hagan, A. E.; Farrington, C. A.; Wall, G. C. and Belz, M. M. (2016). Sodium polystyrene sulfonate for the treatment of acute hyperkalemia: a retrospective study. Clin. Nephrol., 85, 38–43.
[10]
Harel, Z.; Harel, S.; Shah, P. S.; Wald, R.; Perl, J. and Bell, C. M. (2013). Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am. J. Med., 126, 264. e9–264. e24.
[11]
Lillimoe, K. D.; Romolo, J. L.; Hamilton, S. R.; Pennington, L. R.; Burdick, J. F. and Williams, G. M. (1987). Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery, 101, 267–272.
[12]
Ohlsson, A. and Hosking, M. (1987). Complications following oral administration of exchange resins in extremely low-birth-weight infants. Eur. J. Pediatr., 146, 571–574.
[13]
Sherman, S.; Friedman, A. P.; Berdon, W. E. and Haller, J. O. (1981). Kayexalate. A new cause of neonatal bowel opacification. Pediatr. Radiol., 138, 63–64.
[14]
Chaaban, A.; Abouchacra, S.; Gebran, N.; Abayechi, F.; Hussain, Q.; Al Nuaimi, N. and Hassan, M. E. (2013). Potassium binders in hemodialysis patients: a friend or foe? Ren. Fail., 35, 185–188.
[15]
Bunchman, T. E.; Wood, E. G.; Schenck, M. H.; Weaver, K. A.; Klein, B. L. and Lynch, R. E. (1991). Pretreatment of formula with sodium polystyrene sulfonate to reduce dietary potassium intake. Pediatr. Nephrol., 5, 29–32.
[16]
Levy, N.; Boxer, J. and Carter, A. (1973). Citrus juice treated with exchange resins. N. Engl. J. Med., 289, 753–754.
[17]
Cacioppo, P. L. and Hollander, L. (1972). Orange juice treated with exchange resin. N. Engl. J. Med., 287, 361.
[18]
Rivard, A. L.; Raup, S. M. and Beilman, G. J. (2004). Sodium polystyrene sulfonate used to reduce the potassium content of a high-protein enteral formula: a quantitative analysis. JPEN J. Parenter. Enteral. Nutr., 28, 76–78.
[19]
Schröder, C. H.; van den Berg, A. M. J.; Willems, J. L. and Monnens, L. A. H. (1993). Reduction of potassium in drinks by pre-treatment with calcium polystyrene sulphonate. Eur. J. Pediatr., 152, 263–264.
[20]
Thompson, K.; Flynn, J.; Okamura, D. and Zhou, L. (2013). Pretreatment of formula or expressed breast milk with sodium polystyrene sulfonate (Kayexalate(®)) as a treatment for hyperkalemia in infants with acute or chronic renal insufficiency. J. Ren. Nutr., 23, 333–339.
[21]
Van Kamp, G. J.; Bakker, W. and Rosier, J. G. M. C. (1975). Removal of potassium from fruit juices by ion exchange. Br. Med. J., 1, 512–513.
[22]
Bourguignon, C.; Dupuy, A. M.; Coste; T., Michel, F. and Cristol, J. P. (2014). Evaluation of NM-BAPTA method for plasma total calcium measurement on Cobas 8000®. Clin. Biochem., 47, 636–639.
[23]
Tsai, Y. C.; Hung, C. C.; Hwang, S. J.; Wang, S. L.; Hsiao, S. M.; Lin, M. Y.; Kung, L. F.; Hsiao, P. N. and Chen, H. C. (2010). Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease. Nephrol. Dial. Transplant., 25, 1621–1626.
Browse journals by subject