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September 03, 2020
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Patient resources for low-potassium diets ‘likely’ need update to reflect guidelines

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After reviewing patient resources on low-potassium diets for the management of hyperkalemia in chronic kidney disease, researchers from Canada suggested updates be made as the current information fails to address new expert recommendations.

According to Kelly Picard, BSc, RD, of the department of agricultural, food and nutritional sciences at the University of Alberta, and colleagues, current resources often restrict fruits and vegetables, despite the increased attention that has been placed on the potential benefits of plant-based diets for this patient population.

Plant-based diet
Source: Adobe Stock

Several recent publications, including an expert summary on hyperkalemia management, have encouraged plant-based foods for patients with chronic kidney disease and highlighted the impact of potassium additives on total potassium intake,” the researchers elaborated. “The aim of this research brief was to investigate if and/or how current recommendations for low-potassium diet may incorporate these new recommendations.”

For the investigation, Picard and colleagues reviewed resources on dietary potassium restriction from Canada and the United States. The resources included handouts, booklets and printable webpages.

They found that all of the resources recommended restricting fruit and vegetable intake, 67% recommended restricting dairy products, 62% recommended restricting plant-based proteins and 57% recommended restricting whole grain products. In addition, 67% addressed restriction of other foods, such as coffee, tea and chocolate. The least commonly restricted item was ultra-processed food, with only 28% of the resources mentioning restriction of potassium additives in these foods.

Further findings showed the five most commonly restricted foods were bananas, potatoes, oranges, cantaloupe and avocados.

Picard and colleagues contended that because reviewing a handout is considered an effective way to communicate with patients, it is important to understand the nutritional information patients receive from these types of resources.

The restriction found on fruits and vegetables conflicts with the 2020 Kidney Disease Improving Global Outcomes recommendations, which highlight the improved health outcomes that may occur with increased consumption of these types of foods, according to the researchers.

“These new recommendations differ from current teaching materials that predominately restrict plant-based foods to manage hyperkalemia in CKD,” they concluded. “Updates will likely be needed to current resources to reflect new recommendations.”