Is Dietary K Restriction in CKD an Evidence-Based Practice?

Explore the arguments and evidence on whether the common practice of restricting patients with hyperkalemia in CKD from eating whole, minimally processed fruits and vegetables is effective, and the healthiest option. What does the research show?

Hyperkalemia, a potentially life-threatening condition that is common in patients with chronic kidney disease (CKD), especially in those with end-stage kidney disease (ESKD) on hemodialysis, is often assumed to be due to excessive dietary potassium intake. However, there is a lack of evidence supporting a causal relationship between dietary potassium intake and serum potassium concentrations. Hyperkalemia may be caused and/or exacerbated by a myriad of other factors, including hyperglycemia, constipation, metabolic acidosis, and catabolism. 

This course discusses the many possible etiologies of hyperkalemia, suggests effective nutrition interventions, and argues that, because dietary potassium restriction can increase the risk for and/or exacerbate conditions such as cardiovascular disease and hypertension, it should not be the default nutrition intervention. When dietary potassium restriction is warranted, RDNs can take a step-wise approach by helping patients identify and eliminate the most likely culprits first while maintaining a diet rich in fruits and vegetables to promote overall positive health outcomes.