Dietary Potassium Management in Chronic Kidney Disease

Chronic kidney disease (CKD) compromises the kidney’s ability to excrete potassium, placing patients at risk of hyperkalaemia, a potentially life-threatening electrolyte disturbance. Dietary management aims to prevent potassium overload without diminishing overall nutritional quality, since many potassium-rich foods are rich in fibre, antioxidants and alkalinising compounds that confer cardiovascular and metabolic benefits. Effective strategies integrate an understanding of renal and extra-renal potassium handling, the influence of dietary patterns on net potassium load and the role of adjunctive therapies such as gastrointestinal potassium binders. Practical approaches include classifying foods by potassium content relative to fibre, employing cooking techniques to leach potassium from vegetables, and monitoring serum levels to guide individualised dietary prescriptions. Globally, these measures must be adapted to regional food supplies, cooking customs and resource constraints, ensuring equitable access to balanced diets that minimise hyperkalaemia risk while preserving patient quality of life.

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Dietary Potassium Management in Chronic Kidney Disease publication trend

The graph below shows the total number of articles in dietary potassium management in chronic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Chronic kidney disease (CKD): A progressive decline in glomerular filtration rate leading to impaired excretion of metabolic waste and electrolytes.

Hyperkalaemia: An elevated serum potassium concentration that can precipitate cardiac arrhythmias.

Sodium zirconium cyclosilicate (SZC): An oral potassium binder that exchanges sodium for potassium in the gastrointestinal tract to lower serum potassium.

Bioaccessibility: The proportion of potassium released from food matrices during digestion and available for absorption.

DASH dietary pattern: A nutritional protocol emphasising fruits, vegetables and whole grains, originally developed to lower blood pressure.

References

1. Plant-based diet in hyperkalemic chronic kidney disease patients receiving sodium zirconium cyclosilicate: a feasibility clinical trial. American Journal of Clinical Nutrition (2024).
2. Potassium Intake—(Un)Expected Non-Predictor of Higher Serum Potassium Levels in Hemodialysis DASH Diet Consumers. Nutrients (2022).
3. Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function. Nutrients (2018).
4. Potassium Bioaccessibility in Uncooked and Cooked Plant Foods: Results from a Static In Vitro Digestion Methodology. Toxins (2022).