Prolonged Gastric Retention of Sodium Zirconium Cyclosilicate: A Case Report

This is a unique case of prolonged gastric retention of sodium zirconium cyclosilicate (SZC) in a 72-year-old man with multiple comorbidities, including acute kidney injury. Although SZC's radiopacity is a known finding, this patient had no apparent GI motility issues. Serial chest X-rays revealed radiopaque material in his stomach for 11 days after he received the medication. Gastroscopy confirmed that the radiopacity was caused by SZC adhering to the gastric wall, which was successfully removed by irrigation. Following irrigation, imaging showed improved gastric radiopacity. This case highlights that prolonged gastric retention of SZC can occur, potentially increasing the risk of complications. We recommend monitoring the passage of orally administered SZC with imaging studies to prevent such occurrences.