Comparison of Potassium Binders in the ER

Inclusion Criteria: * Plasma potassium \> 5.5 mEq/L * Age ≥18 years * Patient able to provide written informed consent Exclusion Criteria: * Recent bowel surgery * Ileus or bowel obstruction * Pseudohyperkalemia signs and symptoms, such as excessive fist clenching, hemolyzed blood specimen, severe leukocytosis or thrombocytosis * Pregnancy * Active psychiatric disorder * Diabetic ketoacidosis or hyperkalemia caused by any condition for which a therapy directed against the underlying cause of hyperkalemia would be a better treatment option * Dialysis session expected within 4 hours after randomization * History of hypersensitivity to sodium polystyrene sulfonate resin or patiromer * Concurrent use of sorbitol (due to increased risk of intestinal necrosis when used with sodium polystyrene sulfonate)