Let Them Eat Healthy: Can Emerging Potassium Binders Help Overcome Dietary Potassium Restrictions in Chronic Kidney Disease?
Elizabeth Sussman, Bhupinder Singh, Deborah J. Clegg, Biff F. Palmer, Kamyar Kalantar‐Zadeh
Abstract
Potassium-rich foods might provide many health benefits even to people who have declining renal function. The barrier to obtaining these health benefits has long been the concern over hyperkalemia. There are new and novel treatment options available which may enable patients with chronic kidney disease to obtain the health benefits of eating a diet that contains foods such as fruits and vegetables which are high in potassium while reducing the risk of hyperkalemia. We conclude by emphasizing the need for clinical trials with patients on hemodialysis to directly compare the current standard of care, including a potassium-restricted diet, to a potassium-liberalized diet with a potassium binder. The outcome measures would be serum potassium (<5.3 mmol/L), assessments of acidosis, blood pressure, constipation, glycemic control, overhydration, and azotemia, all of which might change in a favorable direction with vegetarian diets as well as quality of life and satisfaction. Potassium-rich foods might provide many health benefits even to people who have declining renal function. The barrier to obtaining these health benefits has long been the concern over hyperkalemia. There are new and novel treatment options available which may enable patients with chronic kidney disease to obtain the health benefits of eating a diet that contains foods such as fruits and vegetables which are high in potassium while reducing the risk of hyperkalemia. We conclude by emphasizing the need for clinical trials with patients on hemodialysis to directly compare the current standard of care, including a potassium-restricted diet, to a potassium-liberalized diet with a potassium binder. The outcome measures would be serum potassium (<5.3 mmol/L), assessments of acidosis, blood pressure, constipation, glycemic control, overhydration, and azotemia, all of which might change in a favorable direction with vegetarian diets as well as quality of life and satisfaction.