Department of Nutrition, University of Nevada, Reno, Nevada, USA.
Department of Nephrology, Nutrition and Dialysis, University Claude Bernard Lyon, Hôpital Lyon Sud, Pierre-Benite, France.
Nutr Rev. 2024 Mar 11;82(4):572-577. doi: 10.1093/nutrit/nuad068.
Diet therapy for hyperkalemia in people with chronic kidney disease (CKD) has shifted considerably in recent years with the observations that reported potassium intake is weakly, or not at all, associated with plasma potassium levels in this population. One of the lingering debates is whether dietary potassium presents a risk of hyperkalemia in the postprandial state. Although there is general agreement about the need for additional research, the commentary by Varshney et al contends that the available research sufficiently demonstrates that high-potassium plant foods do not pose a risk of postprandial hyperkalemia. Others argue that this remains unsettled science. Although the traditional approach of providing people with CKD lists of high-potassium foods to limit or avoid may be unnecessary, those at high risk of hyperkalemia should be encouraged to consume balanced meals and control portions, at least until some of the key research gaps in this area are resolved. This editorial critiques the analyses offered by Varshney et al and explains the rationale for a more cautious approach to care.
近年来，慢性肾脏病 (CKD) 患者的高钾血症饮食疗法发生了重大变化，因为观察到报告的钾摄入量与该人群的血浆钾水平几乎没有关联，或者根本没有关联。一个挥之不去的争论是，膳食钾是否会在餐后状态下导致高钾血症。尽管人们普遍认为需要进行更多的研究，但 Varshney 等人的评论认为，现有研究充分表明，高钾植物性食物不会带来餐后高钾血症的风险。另一些人则认为这仍是一个悬而未决的科学问题。虽然为 CKD 患者提供限制或避免高钾食物清单的传统方法可能没有必要，但应鼓励高钾血症风险人群食用均衡饮食并控制份量，至少在解决该领域的一些关键研究空白之前应如此。本社论批评了 Varshney 等人提供的分析，并解释了对护理采取更谨慎方法的基本原理。
