Kidney Week Educational Symposia-Hyperkalemia, CKD, and Heart Failure: Dietary and Medical Considerations

Video Transcription

Video Summary

Holly Kramer welcomes an international audience, thanks AstraZeneca and organizer Ben Coe, and introduces renal dietitian Melanie Betts to speak about dietary potassium in CKD.<br /><br />Betts explains potassium is essential (recommended intake ~4,700 mg/day), yet most Americans under-consume it due to low fruit and vegetable intake. Higher potassium intake from foods is linked with lower risks of hypertension, cardiovascular disease, stroke, osteoporosis, and kidney stones. She challenges the common, loosely defined “low-potassium diet” advice in CKD, noting it often over-restricts minimally processed plant foods while ignoring potassium from animal proteins and the highly absorbable potassium additives in ultra-processed foods.<br /><br />Referencing KDOQI 2020 and KDIGO 2024, she highlights a guideline shift toward maintaining normal serum potassium, supporting Mediterranean/DASH-style plant-forward patterns, and limiting ultra-processed foods rather than blanket produce restriction. She emphasizes hyperkalemia is multifactorial—worsened by acidosis, hyperglycemia/insulin resistance, and constipation—and that fruits/vegetables can help via alkali and fiber (improving acidosis, glycemic control, and fecal potassium excretion). The session also notes limited access to renal dietitians and stresses individualized, patient-centered management with early dietitian referral. A second talk reviews evidence for adequate dosing of RAS inhibitors and the role of newer potassium binders (patiromer, sodium zirconium cyclosilicate) to control potassium and keep patients on cardio-renal protective therapies.

Asset Subtitle

Moderator(s): Holly Kramer

Presentation(s):

Introduction - Holly Kramer
Dietary Potassium: Effects on Serum Levels and Overall Health - Melanie Betz
Maximization of Renin Angiotensin Aldosterone (RAAS) Inhibition in CKD and Heart Failure: Strategies for Hyperkalemia Management - Jamie Dwyer

Support is provided by an educational grant from AstraZeneca.

Meta Tag

Date 10/24/2024

Pathway 1 CKD Non-Dialysis

Pathway 2 Fluid, Electrolyte, and Acid-Base Disorders

Session ID 495594

Session Type ES - Educational Symposium

Keywords

chronic kidney disease (CKD)

dietary potassium

hyperkalemia management

KDOQI 2020 guidelines

KDIGO 2024 guidelines

Mediterranean and DASH diets

ultra-processed foods and potassium additives

renal dietitian counseling

potassium binders (patiromer, sodium zirconium cyclosilicate)