Nutrition Research Collaborative, Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia.
Nutrients. 2023 Dec 19;16(1):3. doi: 10.3390/nu16010003.
Potassium dysregulation can be life-threatening. Dietary potassium modification is a management strategy for hyperkalaemia. However, a 2017 review for clinical guidelines found no trials evaluating dietary restriction for managing hyperkalaemia in chronic kidney disease (CKD). Evidence regarding dietary hyperkalaemia management was reviewed and practice recommendations disseminated. A literature search using terms for potassium, hyperkalaemia, and CKD was undertaken from 2018 to October 2022. Researchers extracted data, discussed findings, and formulated practice recommendations. A consumer resource, a clinician education webinar, and workplace education sessions were developed. Eighteen studies were included. Observational studies found no association between dietary and serum potassium in CKD populations. In two studies, 40-60 mmol increases in dietary/supplemental potassium increased serum potassium by 0.2-0.4 mmol/L. No studies examined lowering dietary potassium as a therapeutic treatment for hyperkalaemia. Healthy dietary patterns were associated with improved outcomes and may predict lower serum potassium, as dietary co-factors may support potassium shifts intracellularly, and increase excretion through the bowel. The resource recommended limiting potassium additives, large servings of meat and milk, and including high-fibre foods: wholegrains, fruits, and vegetables. In seven months, the resource received > 3300 views and the webinar > 290 views. This review highlights the need for prompt review of consumer resources, hospital diets, and health professionals' knowledge.
钾失衡可能危及生命。饮食钾的调整是治疗高钾血症的一种管理策略。然而，2017 年的一份临床指南综述发现，没有试验评估饮食限制在慢性肾脏病（CKD）中管理高钾血症。对饮食高钾血症管理的证据进行了回顾，并传播了实践建议。从 2018 年到 2022 年 10 月，使用了钾、高钾血症和 CKD 的术语进行了文献检索。研究人员提取数据、讨论研究结果并制定实践建议。开发了一个消费者资源、一个临床医生教育网络研讨会和工作场所教育课程。共纳入 18 项研究。观察性研究发现 CKD 人群的饮食钾和血清钾之间没有关联。在两项研究中，饮食/补充钾增加 40-60mmol 使血清钾增加 0.2-0.4mmol/L。没有研究检查降低饮食钾作为高钾血症的治疗方法。健康的饮食模式与改善的结果相关，并且可能预测较低的血清钾，因为饮食的共同因素可能支持钾向细胞内转移，并通过肠道增加排泄。该资源建议限制钾添加剂、大量肉类和牛奶的摄入量，并包括高纤维食物：全麦、水果和蔬菜。在七个月内，该资源的浏览量超过了 3300 次，网络研讨会的浏览量超过了 290 次。本综述强调了需要及时审查消费者资源、医院饮食和卫生专业人员的知识。
