Chronic renal disease progression

Treatment strategies and potassium intake

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Disordered potassium homeostasis is a common complication of chronic kidney disease and traditional management focuses on restricting potassium intake to avoid hyperkalemia. Permissive potassium intake carries the risk of hyperkalemia and hyperphosphatemia, and possibly may contribute to the development of uremic neuropathy. Excessive potassium restriction and removal by dialysis carries the risk of worsened chronic hypertension, intradialytic hypotension, renal fibrosis and cyst formation, and ventricular arrhythmias. Cohort studies have associated both hypokalemia and hyperkalemia with increased mortality in CKD. A single study of potassium intake in hemodialysis patients found increased intake associated with increased mortality despite adjustment for serum potassium concentration. We recommend avoiding mandatory potassium restriction in early chronic kidney disease. We endorse routine potassium restriction in advanced chronic kidney disease requiring hemodialysis and close monitoring of serum potassium concentration in any patients receiving renin-angiotensin-aldosterone system blockers.

Original languageEnglish
Pages (from-to)290-299
Number of pages10
JournalSeminars in Nephrology
Volume33
Issue number3
DOIs
StatePublished - May 2013

Fingerprint

Chronic Renal Insufficiency
Disease Progression
Potassium
Hyperkalemia
Therapeutics
Renal Dialysis
Hyperphosphatemia
Hypokalemia
Mortality
Renin-Angiotensin System
Disease Management
Serum
Hypotension
Cysts
Cardiac Arrhythmias
Dialysis
Homeostasis
Fibrosis
Cohort Studies
Hypertension

Keywords

  • Chronic kidney disease
  • Dialysis
  • Potassium

ASJC Scopus subject areas

  • Nephrology

Cite this

Chronic renal disease progression : Treatment strategies and potassium intake. / Sinha, Arjun; Agarwal, Rajiv.

In: Seminars in Nephrology, Vol. 33, No. 3, 05.2013, p. 290-299.

Research output: Contribution to journalArticle

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