What dietary advice should I provide to patients with hyperkalaemia to help manage their potassium levels?

For patients with hyperkalaemia, dietary advice should focus on limiting intake of high-potassium foods to help manage and reduce serum potassium levels. Patients should be advised to avoid or restrict foods rich in potassium such as bananas, oranges, tomatoes, potatoes, green leafy vegetables, nuts, seeds, legumes, and certain fruits like apricots and raisins. Additionally, patients should be cautious with potassium-enriched salt substitutes, as these can increase potassium intake and exacerbate hyperkalaemia ¹.

It is important to individualise dietary advice based on the patient's overall clinical condition, including kidney function and medications that may affect potassium levels, such as ACE inhibitors, ARBs, and potassium-sparing diuretics, which can increase the risk of hyperkalaemia ¹. Patients with chronic kidney disease (CKD) should receive tailored dietary counselling, ideally from a specialist renal dietitian, to balance potassium restriction with adequate nutrition and to manage other electrolytes such as phosphate ³.

Recent literature also highlights the role of potassium-enriched salt substitutes, which are generally not recommended in hyperkalaemia due to their potential to raise potassium levels, reinforcing the need for careful dietary potassium management (Xu et al., 2024).

Overall, the key dietary advice is to reduce consumption of potassium-rich foods and avoid potassium-containing salt substitutes, while ensuring that patients receive personalised guidance considering their comorbidities and treatments ¹,³ (Xu et al., 2024).