Potassium Additives and Bioavailability: Are We Missing Something in Hyperkalemia Management?

Hyperkalemia and hyperphosphatemia are common metabolic disturbances in chronic kidney disease. Management may include instructions on a low-potassium or low-phosphorus diet, respectively. Low-phosphorus diet teaching includes information on phosphorus additives in addition to naturally occurring phosphorus food sources. Phosphorus additives are known to be more bioavailable compared with naturally occurring phosphorus. The concentration of phosphorus can also be much higher in processed foods compared with whole foods. Similar considerations may also be needed for dietary potassium teaching. The use of potassium additives in processed foods is growing, and when additives are used, the potassium concentration far exceeds naturally occurring potassium. Evidence also suggests, much like phosphate, potassium additives are more bioavailable than potassium found in whole foods. Clinicians and patients need to be aware of these changes in the food source to ensure potassium diet teaching is effective and safe. (C) 2018 by the National Kidney Foundation, Inc. All rights reserved.