Objective To observe the efficacy and safety of different doses of sodium zirconium cyclic silicate in the treatment of non-dialysis day hyperkalemia in hemodialysis patients.Methods A retrospective analysis of 181 patients with hyperkalemia on hemodialysis from January 2022 to January 2023 was performed.Patients treated with different doses of zirconium silicate sodium powder treatment were divided into the low-dose group and the high-dose group.The venous potassium and adverse reactions were monitored for 6 h,12 h and 24 h after taking the drug in both groups.Results The difference in potassium levels between the two groups at 6 h after SZC treatment was not statistically significant(P>0.05).Comparison of blood potassium levels at 12 h and 24 h after SZC treatment between the two groups,the difference was statistically significant(P<0.05).Comparison of adverse reactions 24 h after taking SZC between the two groups,the difference was not statistically significant(P>0.05).Conclusion Different dose of SZC has good potassium lowering effect 6 h later,but there is no difference in potassium reduction amplitude,high-dose SZC still has good potassium lowering effect at 12 h and 24 h.