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Potassium and Chronic Kidney Disease
This reality challenges approaches that focus solely on total potassium content without considering the source, bioavailability, and degree of food processing. To identify these hidden sources of potassium, it is helpful to check ingredient lists: potassium additives often appear as phosphate, acetate, bicarbonate, lactate, or potassium chloride.
Plant-based intake and blood potassium: a counterintuitive association
Contrary to common belief, dietary patterns rich in plant-based foods, including fruits, vegetables, and legumes have not been consistently associated with higher blood potassium levels in people with moderate CKD (generally up to stage 3, and sometimes stage 4). These types of diets are also linked to better acid-base balance, higher fiber intake, and more regular bowel movements. Together, these factors can help the body manage potassium more effectively, even when kidney function is reduced. These observations suggest that the overall dietary context may be more important than the sheer amount of potassium consumed.
Rethinking potassium restriction: balancing caution and individualization
This is not to downplay the clinical importance of hyperkalemia or to question the need for potassium restriction in certain situations. However, current evidence indicates that a systematic restriction, applied early and without individualization, can compromise overall nutritional quality and reduce intake of essential nutrients, particularly fiber.
Recent literature therefore calls for a more nuanced approach, recognizing the complexity of potassium management in CKD and the need for nutritional expertise to tailor recommendations to the patient’s actual clinical context.
Conclusion
In light of recent data, the role of dietary potassium in the management of chronic kidney disease appears more complex than previously thought. While hyperkalemia remains a serious complication, it cannot be explained solely by diet. Potassium sources, the degree of food processing, and overall dietary patterns all play a central role in potassium balance. Rethinking potassium restriction means adopting an individualized, cautious, and evidence-based approach, rather than relying on generalized food prohibitions.
To learn more about chronic kidney disease, read our article Chronic Kidney Disease and Nutrition.
Sources
Kovesdy CP. Management of hyperkalemia in chronic kidney disease. Nat Rev Nephrol. 2014;10(11):653-662.
Palmer BF, Clegg DJ. Physiologic regulation of potassium balance and implications in chronic kidney disease. Clin J Am Soc Nephrol. 2019;14(8):1253-1262.
Cupisti A, Kovesdy CP, D’Alessandro C, Kalantar-Zadeh K. Dietary potassium intake and risk of hyperkalemia in chronic kidney disease. Nutrients. 2018;10(3):261.
St-Jules DE, Goldfarb DS, Sevick MA. Nutrient non-equivalence: does restricting high-potassium plant foods help to prevent hyperkalemia in CKD? Journal of Renal Nutrition. 2016;26(5):282-287.
Morimoto N, Shioji S, Akagi Y, et al. Associations Between Dietary Potassium Intake From Different Food Sources and Hyperkalemia in Patients With Chronic Kidney Disease. Journal of Renal Nutrition. 2024;34(6):519–529.
Cecchini V, Sabatino A, Contzen B, Avesani CM. Food additives containing potassium, phosphorus, and sodium in ultra-processed foods: potential harms to individuals with chronic kidney disease. Eur J Clin Nutr. 2026;80(1):1–6. doi:10.1038/s41430-025-01600-6
Li L, Wen F, Wang Y, et al. Chronic kidney disease and diet. Renal Replacement Therapy. 2025;11:71:1–14
Pérez-Torres A, Caverni-Muñoz A, González García E. Mediterranean Diet and Chronic Kidney Disease (CKD): A Practical Approach. Nutrients. 2023;15(1):97. doi:10.3390/nu15010097
Author
Lyna is a McGill University–trained registered dietitian and has been a member of the Ordre des diététistes-nutritionnistes du Québec (ODNQ) since 2020. Through several years of varied clinical experience, she has developed a strong interest in science-based nutrition that is meant to be understood and applied in everyday life. Always with her glass of mint tea, she enjoys making complex nutrition concepts clear, practical, and accessible. She is particularly interested in the development of tools and projects with a broad positive impact, supporting informed and sustainable food choices.
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