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Calcium polystyrene sulfonate (CPS), also known as Kalimate, is a cationexchange resin (CER), commonly used to treat hyperkalemia. A case of a patient with chronic kidney disease (CKD) who underwent right hemicolectomy for colonic perforation due to intestinal necrosis secondary to oral CPS administration is presented. The histopathological findings confirmed the colonic ischemia and perforation and showed a luminal deposition of crystals with a fish scale pattern, compatible with CER (Kalimate). This report aims to present and discuss this unusual case considering the most updated scientific evidence.

Kalimate (calcium polystyrene sulfonate) and bowel perforation – a cause not to be ignored