2025 Volume 58 Issue 10 Pages 449-455
Hemodialysis patients often have dietary restrictions set for salt, water, protein, potassium, and phosphorus, which loads a significant psychological burden on them. However, congestive heart failure and hyperkalemia are complications that require daily vigilance. Because dialysis patients do not excrete potassium in urine, it has been considered that potassium intake directly affects serum potassium levels, and a potassium‒restricted diet has typically been recommended. Recently, it was reported that potassium intake and serum potassium levels do not correlate even in dialysis patients. In malnourished dialysis patients (especially the elderly and those with various comorbidities), potassium restriction can further reduce protein intake, which may be associated with a reduced quality of life (QOL) and poor prognosis. Potassium restriction in hemodialysis patients should be implemented based on careful consideration of each individual patient’s circumstances and managed by a medical team that includes staff (nurses, registered dietitians) who favorably communicate with the patient on a daily basis.
