首页|The Highs and Lows of Potassium Intake in CKD—Does One Size Fit All?
The Highs and Lows of Potassium Intake in CKD—Does One Size Fit All?
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NSTL
Amer Soc Nephrology
Electrolyte management is integral to the nephrological care of patients with CKD. Clinicians routinely face potassium derangements in settings of kidney dysfunction; hyperkalemia is of high concern given the potential for life-threatening cardiac arrhythmias. This concern drives recommendations of dietary potassium restriction, with diuretics and potassium-binding resins, to lower plasma potassium in these patients. Although effects of elevated plasma potassium on cardiac arrhythmias are well documented, multiple population studies have suggested a protective effect of potassium-rich diets on kidney function that might delay progression of CKD. In addition to these renoprotective effects, a host of studies have detailed beneficial effects of potassium-rich diets on cardiovascular health, including lower BP, incidence of stroke, and mortality (Figure 1). Together, these reports suggest that potassium supplementation, up to a point, may blunt CKD progression, but prospective studies addressing this hypothesis have been lacking. Recently, Hoorn and colleagues5 initiated a clinical trial (NCT03253172) to test the hypothesis that potassium supplementation slows rates of CKD progression on the basis of eGFR. In this issue of JASN, Gritter et al. report findings from the run-in phase of this clinical trial, “Effects of Short-Term Potassium Chloride Supplementation in Patients with Chronic Kidney Disease.”
Andrew S. Terker、Turgay Saritas、Alicia A. McDonough
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Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical
NSTL
Amer Soc Nephrology
