Moderate stepwise restriction of potassium intake to reduce risk of hyperkalemia in chronic kidney disease: A literature review

Abstract

A potassium-rich diet has several cardiovascular and renal health benefits; however, it is not recommended for patients with advanced chronic kidney disease or end-stage kidney disease because of the risk of life-threatening hyperkalemia. To assess the strength of evidence supporting potassium intake restriction in chronic kidney disease, the medical literature was searched looking for the current recommended approach and for evidence in support for such an approach. There is a lack of strong evidence supporting intense restriction of dietary potassium intake. There are several ways to reduce potassium intake without depriving the patient from fruits and vegetables, such as identifying hidden sources of potassium (processed food and preservatives) and soaking or boiling food to remove potassium. An individualized and gradual reduction of dietary potassium intake in people at risk of hyperkalemia is recommended. The current potassium dietary advice in chronic kidney disease needs to be reevaluated, individualized, and gradually introduced.

Keywords: Chronic kidney disease; Potassium intake; Plant-based diet; Hyperkalemia; Potassium removal

Core Tip: A potassium-rich diet has several cardiovascular and renal health benefits; however, it is not recommended for patients with advanced chronic kidney disease or end-stage kidney disease because of the risk of life-threatening hyperkalemia. However, there is a lack of strong evidence supporting this restrictive approach. There are several ways to reduce potassium intake without depriving the patient of fruits and vegetables, such as identifying hidden sources of potassium (processed food and preservatives) and soaking or boiling food to remove potassium. An individualized and gradual reduction of dietary potassium intake in people at risk of hyperkalemia is recommended.