Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2026
Liberal fruit and vegetable intake in patients with advanced CKD with or without Sodium zirconium cyclosilicate.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Moest Wouter T, Snoeker Brigitte, Mallat Marko J K, Vermanen Laurens A H, Kuipers Hidde T, de Borst Martin H, Vogt Liffert, Hoorn Ewout J, Rotmans Joris I
Аннотация
INTRODUCTION: Higher dietary potassium intake is associated with lower blood pressure, better kidney outcomes and improved survival. However, the risk of hyperkalemia limits implementation of healthy potassium-rich diets in patients with chronic kidney disease(CKD). Novel potassium binders such as sodium zirconium cyclosilicate(SZC) may enable a more liberal intake of potassium-rich diets and thereby enable their cardiorenal benefits.
METHODS: This randomized, crossover, non-inferiority clinical trial included 16 CKD patients receiving RAAS inhibitors. Participants followed, in a randomized order, a potassium-rich diet for 6 weeks (adding 40mmol potassium/day via extra fruits, vegetables and nuts) or their regular diet. Hyperkalemia (>5.5mmol/l) was managed with SZC, while continuing the diet. The primary endpoint was serum potassium after 6 weeks, with a non-inferiority margin of 0.5mmol/l.
RESULTS: At 6 weeks, there was no significant difference in serum potassium between the control and potassium-enriched diet phases (between-group difference 0.03mmol/L, 95%CI-0.32to0.27;p=0.850). In contrast,24-hour urinary potassium excretion increased significantly during the potassium-enriched diet (between-group difference 24.7mmol/24h, 95%CI8.0to 41.3; p=0.005). Two patients developed hyperkalemia (5.9 and 6.1 mmol/L) and were treated with SZC, after which the diet was continued without recurrence.
CONCLUSION: A potassium-rich diet was consistent with non-inferior serum potassium levels compared with a regular diet at 6 weeks in patients with advanced CKD receiving RAAS inhibition. Hyperkalemia occurred in a minority of patients, and was effectively managed with SZC, allowing continuation of both the diet and RAAS inhibition. These findings suggest that a potassium-rich diet may be feasible in selected patients with advanced CKD, with careful monitoring and use of SZC when needed.
METHODS: This randomized, crossover, non-inferiority clinical trial included 16 CKD patients receiving RAAS inhibitors. Participants followed, in a randomized order, a potassium-rich diet for 6 weeks (adding 40mmol potassium/day via extra fruits, vegetables and nuts) or their regular diet. Hyperkalemia (>5.5mmol/l) was managed with SZC, while continuing the diet. The primary endpoint was serum potassium after 6 weeks, with a non-inferiority margin of 0.5mmol/l.
RESULTS: At 6 weeks, there was no significant difference in serum potassium between the control and potassium-enriched diet phases (between-group difference 0.03mmol/L, 95%CI-0.32to0.27;p=0.850). In contrast,24-hour urinary potassium excretion increased significantly during the potassium-enriched diet (between-group difference 24.7mmol/24h, 95%CI8.0to 41.3; p=0.005). Two patients developed hyperkalemia (5.9 and 6.1 mmol/L) and were treated with SZC, after which the diet was continued without recurrence.
CONCLUSION: A potassium-rich diet was consistent with non-inferior serum potassium levels compared with a regular diet at 6 weeks in patients with advanced CKD receiving RAAS inhibition. Hyperkalemia occurred in a minority of patients, and was effectively managed with SZC, allowing continuation of both the diet and RAAS inhibition. These findings suggest that a potassium-rich diet may be feasible in selected patients with advanced CKD, with careful monitoring and use of SZC when needed.