Sodium zirconium cyclosilicate - unexpected finding in management of hyperkalemia

Abstract Known case of End stage renal disease (ESRD) patient on regular haemodialysis thrice weekly had developed hyperkalemia during his admission to intensive care unit and was treated with sodium zirconium cyclosilicate. The patient underwent a CT scan of abdomen, and pelvis showing radiopaque fluid in stomach and colon, although the patient had not been given any oral or IV contrast and didn't receive any drugs or supplements that could appear radiopaque. Given the known radiopaque nature of zirconium-based dental implants, it was suggested that the sodium zirconium cyclosilicate administered to the patient was responsible for the radiopacity seen on the scan. This illustrates the importance of recognizing potential causes of different imaging appearances and eliminating artifacts before scanning or considering the use of radiopaque medications as alternatives to contrast agents.