Potassium intake from foods does not appear to predispose patients receiving hemodialysis (HD) to hyperkalemia or lead to death, according to new study findings presented at Kidney Week 2020 Reimagined, a virtual meeting of the American Society of Nephrology.

In the international DIET-HD study, 8043 patients had a median dietary potassium intake at baseline of 3.5 g per day. During a median of 4 years, 36% of patients died, including 45% from cardiovascular causes.

After adjustment for baseline characteristics that included presence of cardiac disease and food groups, dietary potassium intake was not significantly associated with all-cause mortality, Amélie Bernier-Jean, MD, PhD, of the University of Sydney in Sydney, New South Wales, Australia, and colleagues reported. A mediation analysis also found no evidence of an association of dietary potassium with mortality either through or independent of serum potassium levels. Additionally, in a cross-sectional analysis, higher potassium intake at baseline was not significantly associated with either higher serum potassium or hyperkalemia of 5.5 mEq/L or greater or 6.0 mEq/L or greater at baseline.

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“People treated with maintenance hemodialysis are advised to limit intake of potassium-rich fruits and vegetables to prevent hyperkalemia, arrhythmia, and death. Recently, the lower certainty of evidence supporting dietary potassium has been recognized,” Dr Bernier-Jean’s team stated. “We found no evidence of an independent association between potassium intake and all-cause mortality, and we did not find a significant association between dietary potassium intake and serum potassium levels.”

Disclosure: This clinical trial was supported by Diaverum. Please see the original reference for a full list of authors’ disclosures.


Bernier-Jean A, Wong G, Saglimbene VM, et al. Dietary potassium intake and all-cause mortality in adults undergoing hemodialysis: the DIET-HD cohort study. Presented at: Kidney Week 2020 Reimagined, October 19-25, 2020. Poster PO1140.