Guidance Issued on Impact, Management of Potassium, Phosphorus in CKD
THURSDAY, Sept. 25, 2025 -- Guidance is presented for understanding the impact of potassium and phosphorus additives on people with chronic kidney disease (CKD) and managing their consumption in a paper published online Sept. 18 in the Journal of the American Society of Nephrology.
Noting that potassium and phosphorus are ubiquitous in processed foods, Annabel Biruete, Ph.D., from Purdue University in West Lafayette, Indiana, and colleagues examined whether all potassium and phosphorus additives are uniformly detrimental in the context of CKD.
The authors note that potassium additives may be beneficial in patients at low risk for hyperkalemia; when restriction is needed, interventions could range depending on the level of hyperkalemia risk. Phosphorus additives entail no health benefits and higher consumption may stimulate counter-regulatory hormones resulting in adverse outcomes such as bone disease, according to the authors; consequently, limiting their intake is recommended for all patients with CKD. Basic dietary strategies for reducing the risk for hyperkalemia from potassium additives include planning balanced meals, preparing meals with minimally processed foods/ingredients, recommending alternatives to less healthy foods, and controlling portion size; advanced strategies include avoiding salt substitutes, limiting or avoiding foods and ingredients containing potassium additives, avoiding injected cuts of meat or poultry, and limiting added potassium from supplements; intensive strategies include avoiding foods with high-risk potassium additives and reducing exposure through extensive diet analysis and individualization. Basic and advanced dietary strategies are generally similar for reducing risks from phosphorus additives, while intensive strategies include increasing awareness of phosphorus additives.
"Helping people with kidney disease become not only aware but better equipped to manage their nutrition is a vital and complex undertaking," Biruete said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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