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Abstract: TH-PO781

Potassium Diet Restriction in Elderly Patients With CKD: Is It Needed?

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Innecchi, Mariana Leister Rocha, Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
  • Avesani, Carla Maria, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Coelho, Venceslau Antonio, Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
  • Lauar, Julia, Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
  • Costa, Tiago Emanuel, Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
  • Moyses, Rosa M.A., Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
  • Elias, Rosilene M., Universidade de Sao Paulo Instituto de Ciencias Biomedicas, Sao Paulo, São Paulo, Brazil
Background

Most guidelines in chronic kidney disease (CKD) advise that potassium (K+) intake is to be restricted if hyperkalemia is present. For older patients with CKD, this dietary recommendation which decreases the intake of vegetables, legumes, fruits, and whole cereals may lead to poor diet and predispose the development of malnutrition and sarcopenia. Since observational studies have challenged the association between K intake and hyperkalemia, we aimed to investigate in a group of older patients with CKD the association between K+ intake and serum K+.

Methods

This is a cross-sectional analysis of patients > 70 yrs. with stage 4/5 CKD on conservative management. We assessed dietary K+ intake by 24-hour dietary recall. Hyperkalemia was defined as K > 5.0mmol/L.

Results

We included 54 patients (81 ± 7 yr, 59.3% men, body mass index 25.5 ± 4.4 kg/m2, 61.1% diabetic, eGFR 20.1 ± 6.9 ml/min, 20.4% below recommended weight). Hyperkalemia was found in 19 patients (35.2%), being more frequent among diabetics (80% vs 20% of non-diabetics, p=0.014). Serum K+ did not correlate with eGFR, albumin, sex, age, or urea. K+ dietary intake and serum K+ were 1,375 mg/day (870-1,812) and 4.8 ± 0.6 mEq/L, respectively, without a significant correlation between them (r=0.210, p=0.160).) Also, K+ intake was similar between patients with and without hyperkalemia [1,581 (863-2,000) and 1,375 (878-1,543), p=0.363).

Conclusion

Older patients with moderate/advanced CKD did not have a high K+ intake and it was not associated with serum K+. Considering that these patients may be at risk for malnutrition, a K+ dietary restriction must be individually evaluated considering the patients clinical and nutritional condition.