title: Nutrient Non-equivalence: Does Restricting High-Potassium Plant Foods Help to Prevent Hyperkalemia in Hemodialysis Patients?
abstract: Hemodialysis patients are often advised to limit their intake of high-potassium foods to help manage hyperkalemia. However, the benefits of this practice are entirely theoretical and not supported by rigorous randomized controlled trials. The hypothesis that potassium restriction is useful is based on the assumption that different sources of dietary potassium are therapeutically equivalent. In fact, animal and plant sources of potassium may differ in their potential to contribute to hyperkalemia. In this commentary, we summarize the historical research basis for limiting high-potassium foods. Ultimately, we conclude that this approach is not evidence-based and may actually present harm to patients. However, given the uncertainty arising from the paucity of conclusive data, we agree that until the appropriate intervention studies are conducted, practitioners should continue to advise restriction of high-potassium foods.
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: davidstjules@gmail.com.
authors.forename: David E
authors.initials: DE
authors.lastname: St-Jules
authors.affiliation: Division of Nephrology, Department of Medicine, New York University School of Medicine, New York, New York.
authors.forename: David S
authors.initials: DS
authors.lastname: Goldfarb
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Sevick
mesh_terms: D005502:Food; D006801:Humans; D006947:Hyperkalemia / Q000517:prevention & control*; D011188:Potassium; D017419:Potassium, Dietary; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis
chemical_list: D017419:Potassium, Dietary; D011188:Potassium