Kayexalate is a potentially harmful therapy to treat hyperkalemia, it has a slow onset action (if at all) and doubtful efficacy. It also carries risk of life threatening gastrointestinal complications. There is NO CONVINCING EVIDENCE that Kayexalate increases fecal potassium losses.
Kayexalate in Hyperkalaemia – A review of the literature shows that there is virtually NO BENEFIT in the emergent setting to the use of kayexalate. But is there a downside? As with all medications, there is. In this case, there is a rare but highly lethal complication of the drug: Colonic Necrosis.