New Insights Into Dietary Approaches to Potassium Management in Chronic Kidney Disease

Sumida K 1 , Biruete A 2 , Kistler BM 3 , Khor BH 4 , Ebrahim Z 5 , Giannini R 6 Show all authors , Sussman-Dabach EJ 7 , Avesani CM 8 , Chan M 9 , Lambert K 10 , Yee-Moon Wang A 11 , Clegg DJ 12 , Burrowes JD 13 , Palmer BF 14 , Carrero JJ 15 , Kovesdy CP 16

Affiliations 

  • 1 Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee. Electronic address: ksumida@uthsc.edu
  • 2 Department of Nutrition and Dietetics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana; Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Nutrition Science, Purdue University, West Lafayette, Indiana
  • 3 Department of Nutrition Science, Purdue University, West Lafayette, Indiana; Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
  • 4 Faculty of Food Science and Nutrition, University Malaysia Sabah, Kota Kinabalu, Malaysia
  • 5 Division of Human Nutrition, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
  • 6 Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
  • 7 Department of Family and Consumer Sciences, California State University, Northridge, Northridge, California
  • 8 Division of Renal Medicine, Baxter Novum. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  • 9 Departments of Nutrition and Dietetics and Renal Medicine, The St. George Hospital, Kogarah, New South Wales, Australia
  • 10 Faculty of Science, Medicine and Health, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
  • 11 Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
  • 12 Department of Internal Medicine, Paul Foster School of Medicine, Texas Tech Medical Center, El Paso, Texas
  • 13 Department of Health Sciences and Administration, Program in Nutrition and Dietetics, Long Island University-Post, Greenvale, New York
  • 14 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
  • 15 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • 16 Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
J Ren Nutr, 2023 Nov;33(6S):S6-S12.
PMID: 37610407 DOI: 10.1053/j.jrn.2022.12.003

Abstract

Potassium disorders are one of the most common electrolyte abnormalities in patients with chronic kidney disease (CKD), contributing to poor clinical outcomes. Maintaining serum potassium levels within the physiologically normal range is critically important in these patients. Dietary potassium restriction has long been considered a core strategy for the management of chronic hyperkalemia in patients with CKD. However, this has been challenged by recent evidence suggesting a paradigm shift toward fostering more liberalized, plant-based dietary patterns. The advent of novel potassium binders and an improved understanding of gastrointestinal processes involved in potassium homeostasis (e.g., gastrointestinal potassium wasting) may facilitate a paradigm shift and incorporation of heart-healthy potassium-enriched food sources. Nevertheless, uncertainty regarding the risk-benefit of plant-based diets in the context of potassium management in CKD remains, requiring well-designed clinical trials to determine the efficacy of dietary potassium manipulation toward improvement of clinical outcomes in patients with CKD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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