Affiliation:
1. Department of Agricultural, Food, and Nutritional Sciences, Li Ka Shing Centre for Health Innovation, University of Alberta, Edmonton, Alberta, Canada
2. Nutrition Services, Alberta Health Services, Edmonton, Alberta, Canada
Abstract
Abstract
The prevalence of chronic kidney disease (CKD) is increasing and dietary interventions may be a strategy to reduce this burden. In the general population, higher potassium intake is considered protective for cardiovascular health. Due to the risk of hyperkalemia in CKD, limiting potassium intake is often recommended. However, given that poor cardiovascular function can cause kidney damage, following a low-potassium diet may be deleterious for patients with CKD. The aim of this systematic review was to summarize the evidence on dietary potassium intake and CKD progression. Multiple databases were searched on 7 June 2019 and data were managed with Covidence. No intervention trials met the inclusion criteria. Eleven observational studies met the inclusion criteria (10 post hoc analyses, 1 retrospective cohort), representing 49,573 stage 1–5 predialysis patients with CKD from 41 different countries. Of the 11 studies, 6 studies reported exclusively on early CKD (stage 1–2), 4 studies separately reported analyses on both early and late (stage 3–5) CKD, and 2 studies reported exclusively on late CKD. A total of 9 studies reported risk of disease progression in early CKD; in 4 studies high potassium intake was associated with lower risk, while in 2 studies the low intake showed a higher progression of risk, and 3 studies reported no relation. In late CKD, results are mixed: 2 studies suggested benefit of higher potassium intake and 1 suggested benefit of lower potassium intake, whereas 3 studies were neutral. These results should be interpreted with caution, as considerations preventing firm conclusions include 1) the overall low range of dietary potassium intake, with all studies reporting an average intake below the 2004 Kidney Disease Outcomes Quality Initiatives guidelines, and 2) the method used to assess potassium intake in most studies (i.e., urine) in late stages of CKD. Ideally, well-controlled intervention studies are needed to understand how dietary potassium intake is linked to CKD progression.
Funder
Canadian Institutes of Health Research
Natural Sciences and Engineering Research Council of Canada
Dairy Farmers of Canada
Publisher
Oxford University Press (OUP)
Subject
Nutrition and Dietetics,Medicine (miscellaneous),Food Science
Reference46 articles.
1. Changes in the US burden of chronic kidney disease from 2002 to 2016: an analysis of the Global Burden of Disease Study;Bowe;JAMA,2018
2. Potassium and health;Weaver;Adv Nutr,2013
3. Sodium and potassium intake: effects on chronic disease outcomes and risks;Newberry;Compartive Effectiveness Review,2018
4. Meta-analysis of potassium intake and the risk of stroke;Vinceti;J Am Heart Assoc,2016
5. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses;Aburto;BMJ,2013
Cited by
30 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献