Evidence map›Paper›PMID 33121888›Full record

ArticleJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation2021

Dietary Potassium Intake and Mortality in a Prospective Hemodialysis Cohort.

Yoko Narasaki, Yusuke Okuda, Sara S Kalantar, Amy S You, Alejandra Novoa, Theresa Nguyen, Elani Streja, Tracy Nakata, Sara Colman, Kamyar Kalantar-Zadeh and 2 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
2.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 35 citations in OpenAlex.

  1. Review
  2. ASN Kidney Health Guidance on Potassium and Phosphorus Food Additives.Journal of the American Society of Nephrology : JASN · 2025
    Article
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  12. Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2023
    Review
  13. Article
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  16. Review
  17. Article
  18. Review
  19. Hyperkalemia in patients undergoing hemodialysis: Its pathophysiology and management.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2022
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 2 countries.

Yoko NarasakiDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California; Department of Clinical Nutrition and Food Management, Tokushima University Graduate School of Nutrition and Biosciences, Tokushima, Japan; Japan Society for the Promotion of Science, Tokyo, Japan; Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
Yusuke OkudaDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California.
Sara S KalantarDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California; University of California, Berkeley, Berkeley, California.
Amy S YouDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California.
Alejandra NovoaDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California.
Theresa NguyenDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California.
Elani StrejaDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California; Tibor Rubin Veterans Affairs Medical Center, Long Beach, California.
Tracy NakataDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California.
Sara ColmanDaVita Inc., El Segundo, California.
Kamyar Kalantar-ZadehDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California; Tibor Rubin Veterans Affairs Medical Center, Long Beach, California.
Danh V NguyenDivision of General Internal Medicine, University of California, Irvine, Orange, California.
Connie M RheeDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California, Irvine, Orange, California. Electronic address: crhee1@uci.edu.
University of California, Irvine · US

Funding

MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Hypothyroidism, Cardiovascular Health, and Survival in Kidney DiseaseK23DK102903 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2014 to 2018
$955k
A Pilot Feasibility Trial of Thyroid Hormone Replacement in Dialysis PatientsR03DK114642 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2017 to 2018
$155k
NIDDK NIH HHS K23 DK102903NIDDK NIH HHS K24 DK091419NIDDK NIH HHS R03 DK114642
6 · The paper itself

Abstract

objectivesAmong hemodialysis patients, clinical practice guidelines recommend dietary potassium restriction given concerns about potential hyperkalemia leading to malignant arrhythmias and mortality. However, there are sparse data informing recommendations for dietary potassium intake in this population. We thus sought to examine the relationship between dietary potassium intake and death risk in a prospective cohort of hemodialysis patients. DESIGN AND

methodsAmong 415 hemodialysis patients from the prospective "Malnutrition, Diet, and Racial Disparities in Chronic Kidney Disease" cohort recruited across 16 outpatient dialysis clinics, information regarding dietary potassium intake was obtained using Food Frequency Questionnaires administered over October 2011 to March 2015. We first examined associations of baseline dietary potassium intake categorized as tertiles with mortality risk using Cox regression. We then examined clinical characteristics associated with low dietary potassium intake (defined as the lowest tertile) using logistic regression.

resultsIn expanded case-mix Cox analyses, patients whose dietary potassium intake was in the lowest tertile had higher mortality (ref: highest tertile) (adjusted hazard ratio 1.74, 95% confidence interval 1.14-2.66). These associations had even greater magnitude of risk following adjustment for laboratory and nutritional covariates (adjusted hazard ratio 2.65, 95% confidence interval 1.40-5.04). In expanded case-mix restricted cubic spline analyses, there was a monotonic increase in mortality risk with incrementally lower dietary potassium intake. In expanded case-mix logistic regression models, female sex; higher serum bicarbonate; and lower dietary energy, protein, and fiber intake were associated with low dietary potassium intake.

conclusionsIn a prospective cohort of hemodialysis patients, lower dietary potassium intake was associated with higher mortality risk. These findings suggest that excessive dietary potassium restriction may be deleterious in hemodialysis patients, and further studies are needed to determine the optimal dietary potassium intake in this population.

Indexed as

Potassium, DietaryRenal Insufficiency, ChronicCohort StudiesFemaleHumansPotassiumProspective StudiesRenal DialysisPotassiumPotassium, Dietary

Identifiers

PMID33121888
PMCPMC8614638
OpenAlexW3097853277

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.