potassium level intake not settled science

[70Beach]

interesting article about studies concerning CKD and potassium intake. ncbi.nlm.nih.gov/pmc/articl...

[Bassetmommer NKF Ambassador]

Here's the thing about potassium. It is a balancing act. It as dangerous to have it too high as it is too low. CKD causes the impaired kidney filtration capabilities to fail. If you are at a lower stage, like4 or 5, minerals such as phosphorous and potassium do not get removed from the blood correctly and build up which is why the concern with consuming lower potassium products. BUT here is the thing; If your potassium levels are fine, then stop worrying about it. You said you were stage 3 and at that level, being aware is good. But it is not as critical at this stage unless your labs indicate elevation in potassium and phosphorous. You did not say if your potassium levels were elevated. If not, then consume what you want within moderation and be careful with those known high potassium products. If they start to increase as your CKD progresses, then you will have to change up what you consume. Also make sure you check your medicine, especially blood pressure meds which can also increase potassium. It is truly up to you to monitor your labs and know your values. If your potassium is getting up near 5 or over, then lower your potassium intake. If they are normal, enjoy your food!

[RonZone]

Hey, thank your lucky stars you are at 3a at age 70. I'm 70 and just started PD. But yeah, cut out processed food, fast food, high sodium food, and just eat healthy with lots of fruits and veggies if you don't have other issues to prevent it and ENJOY life!

[RonZone]

Oh and basically this says "To the best of our knowledge, there is currently no review reporting the findings of studies regarding restriction of potassium intake in CKD and its impact on delaying disease progression, improving hyperkalemia rates, or reducing mortality. " Which translates to "These folks don't really know". Like with a LOT of things CKD, MUCH more testing and trials will need to occur before we really know for sure if reducing potassium intake at level 4 and 5 help slow the progression of CKD. I think most of us realize that a lot of things CKD still fall into that "we just don't know, definitively" category, other than transplant and dialysis. Maybe one day!

[CKDnomore3953]

Hi 70Beach,

Thanks for providing the link to the studies on potassium level intakes. The quote I found most pertinent/interesting in this article is this:

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(1). Potassium is a considered a vital nutrient for human health (2). In the general population, higher dietary potassium intake reduces cardiovascular risk factors (3–5). A systematic review of randomized controlled trials found that higher potassium intake from fruits and vegetables was cardioprotective (6). Additionally, in a cross-sectional study in >500,000 older adults in free-living conditions, the highest quartile of potassium intake (5.5 g/d) was associated with the lowest risk of experiencing death from a renal cause (7). Potassium positively affects cardiovascular function and hypertension through the following: 1) potassium's role in vasodilation and 2) by reducing the intravascular volume of blood plasma through reduced sodium reabsorption (2). Additionally, lower dietary acid load is hypothesized to be protective for kidney health (8–10) and a higher potassium intake lowers dietary acid.

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Especially this section:

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In >500,000 older adults in free-living conditions, the highest quartile of potassium intake (5.5 g/d) was associated with the lowest risk of experiencing death from a renal cause

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I am a 74 year old woman with CKD3a since 2008, although I was not diagnosed until 2019. After diagnosis I looked back at my blood tests and saw that my eGFR had been between 47-60 since 2008 (2008 is as far back as my available records go.) On my most recent blood test in Feb 2023 my eGFR was 55.

The only advice my PCP has given me is to lower salt and protein intake and increase my daily water consumption. I requested a referral to a Renal dietitian, but the ONLY dietitian in my medical group is a Diabetes dietitian. (I don’t have diabetes). I had an appointment with her and she told me that at least 50% of the diabetes patients she works with also have CKD, and all of the patients she works with are on statin drugs to lower their cholesterol. She provided handouts to me on the diet she recommends for her diabetes patients.

I have been following a mostly Whole Foods Plant Based diet since 2019. My eGFR has remained stable on this diet - but my eGFR was stable also between 2008-2019 when I did not know I had CKD and was eating a gluten free lactose free diet due to Leaky Gut Syndrome. Like you I initially lost weight on the plant based diet. I was strictly monitoring my salt intake and potassium intake and was feeling weak and tired most of the time. However, since my potassium levels on my blood tests have also been stable (3.39 mmol/l) I added many high potassium foods like avocados, all kinds of dry roasted, unsalted nuts and beans back into my diet. My weight stabilised and I feel much better. I am 5’6” and weigh 150 lbs.

I have done a lot of research on Kidney disease since 2019 and my overall impression is that there is still a lot of needed research to be done by the medical research community to understand the root causes of Kidney disease and ways to treat the disease to provide better outcomes to patients.

For me the bottom line is that we all have to be our own Health Advocates and find what works best for us. The same diet will not work for everyone.

Take a look at the information provided here:

kidneyhood.org/?_kx=UpmShg3...

I wish peace, joy and improving kidneys for you,

Lynne

[OldTownhammock]

Now I really don't know what to do

[Blackknight1989]

Don’t think that’s the true meaning of your link (to the OP). Instead, what I believe that link posted alludes to is the fact that ALL renal diets should be closely coordinated with the individual’s health. For me, whether I eat K first or last matters not…instead what matters is the amount of K I have daily does not need to exceed a certain lower amount AND needs to be relatively consistent daily. However, my daily intake of K may or may NOT be what yours or anybody else’s daily intake of K should be. Too often it’s easy to generalize with our issues and that, especially when affecting something as important as what you put into your body to fuel it, can cause a major health issue/emergency. Thus, individual education of both your condition AND your disease is vitality important. As I have found dealing with stage 4 CKD diagnosis followed 8 days later by AKI and 6 months in an ICU at age 29 (over 29 years ago) is that my K requirements don’t match yours or anyone be else’s. Instead we need individualized care and directives from our health care providers for only me (or you as the patient) instead of a “groupthink” type treatment plan. Unfortunately finding a provider to provide such specific care is often times elusive. My best to you!