Kidney Week

Abstract: TH-PO1247

Dietary Potassium Liberalization with Fruits and Vegetables in People with CKD: A Randomized Crossover Clinical Trial

Session Information

• Late-Breaking Research Posters
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Tangri, Navdeep, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Navdeep Tangri, MD, PhD

• Ziaei, Rahele, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Rahele Ziaei, PhD

• Mahboobi, Sepideh, University of Manitoba, Winnipeg, Manitoba, Canada

Sepideh Mahboobi, PhD

• Tavakoli, Leila, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Leila Tavakoli, MSc

• Brar, Ranveer Singh, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Ranveer Singh Brar

• Cahill, Leah E., Dalhousie University, Halifax, Nova Scotia, Canada

Leah E. Cahill, PhD, RD

• Balshaw, Robert, University of Manitoba, Winnipeg, Manitoba, Canada

Robert Balshaw, PhD

• Mcnutt, Sarah, Health Sciences Centre Winnipeg, Winnipeg, Manitoba, Canada

Sarah Mcnutt, RD

• Fitzsimmons, Andrea, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada

Andrea Fitzsimmons, RD, RDN

• Seniuk, Brie, Health Sciences Centre Winnipeg, Winnipeg, Manitoba, Canada

Brie Seniuk, RD

• Hager, Drew, University of Manitoba, Winnipeg, Manitoba, Canada

Drew Hager, MD

• Hingwala, Jay P., University of Manitoba, Winnipeg, Manitoba, Canada

Jay P. Hingwala, MD, MSc

• Mollard, Rebecca, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Rebecca Mollard, PhD

• MacKay, Dylan, University of Manitoba, Winnipeg, Manitoba, Canada

Dylan MacKay, PhD

Background

Hyperkalemia is associated with increased mortality in people with chronic kidney disease (CKD). Dietary potassium (dK) restriction is recommended to reduce hyperkalemia risk but may limit fruit and vegetable (F+V) intake, diet quality, and quality of life. We evaluated the impact and safety of dK liberalization via F+V on serum potassium in people with CKD.

Methods

We conducted an open-label, randomized 2-period crossover trial in 30 people with CKD in Winnipeg, Canada. Eligible participants had eGFR 15-45 ml/min/1.73m² and serum potassium 4.5-5.5 mEq/L. Following a 2-week liberalized dK run-in, participants were randomized to 6 weeks of either a liberalized dK diet (target 2000 mg/day) or standard dK diet (target 500 mg/day), using high or low-potassium F+V provided via weekly grocery delivery. After a 2-week washout, participants crossed over to the dK diet. The primary outcome was serum potassium. Secondary outcomes included quality of life, physical function, blood pressure and biochemical markers.

Results

Of 63 participants screened, 38 were eligible and 30 randomized. Two participants developed hyperkalemia during run-in. Follow-up data was available for 93% of participants. Two participants did not complete the final visit (sudden cardiac death, n=1; hyperkalemia, n=1). Hyperkalemia occurred in 1 versus 0 participants during liberalized versus standard dK. There was no difference in serum potassium levels between diets (MD: −0.014; 95% CI, −0.199 to 0.171; P=0.875). However, urinary potassium excretion was higher (MD: + 15.464; 95% CI, 7.606, to 23.323; P <0.001) with liberalized dK. No differences were found in secondary outcomes.

Conclusion

Liberalizing dK from F+V increased urinary potassium excretion without increasing serum potassium in people with CKD.

Figures show n=28 completers with both the Standardized-period and Liberalized-period endpoint values. Colored dots/lines show individual participnt values; black lines show unadjusted mean at the end of each period for each sequence group (diamond marker- Liberalized to Standard, square marker Standard to Liberalized)

Funding

• Government Support - Non-U.S.