Experiences of the Dietary Management of Serum Potassium in Chronic Kidney Disease: Interviews With UK Adults on Maintenance Hemodialysis

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    Abstract

    Objective
    Dietary potassium restrictions in kidney disease are complex to follow and may reduce quality of life. However, details on this impact are sparse. We therefore sought to explore patients’ perspectives on the experienced impact of following low-potassium diets, to inform clinical practice and research.
    Design and Methods
    Qualitative semistructured interviews were undertaken in a UK teaching hospital with adults undergoing maintenance hemodialysis. Audio-recorded, transcribed interviews underwent thematic analysis.
    Results
    34 adults (19 women, 15 men, and mean age 66.7 ± 10.9 years) with chronic kidney disease (CKD) participated. Our analysis identified three themes with subthemes: “ What is left for me to eat now?”; “I'm obviously different”; “ Food can be socially awkward”, and one outlying theme: “ Money doesn't grow on trees.” Practical difficulties experienced when coming to terms with dietary restrictions meant testing out advice and experimenting with low- and high-potassium foods, to find a reasonable compromise, despite worries they could die from eating too much potassium. Interactions with food providers were dependent on pre-existing relationships, and maintaining these, at the expense of their dietary needs. Obtaining dietary requirements in restaurants often resulted in conflict with less concern for maintaining a relationship with those in the restaurant. Some individuals experienced financial difficulties, and decisions were made to prioritize family needs over their own dietary requirements.
    Conclusion
    Low-potassium diets bring practical and psychosocial consequences which significantly impacts people living with CKD. Renal health professionals should offer more support to people on a low-potassium diet. Public education on dietary potassium requirements in CKD, particularly in the food service industry to increase awareness, may be a worthwhile intervention.
    Original languageEnglish
    Pages (from-to)556-560
    Number of pages5
    JournalJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
    Volume30
    Issue number6
    Early online date6 Apr 2020
    DOIs
    Publication statusPublished - Nov 2020

    Bibliographical note

    NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Renal Nutrition. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Renal Nutrition, 30:6, (2020) DOI: 10.1053/j.jrn.2020.01.025

    © 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

    Keywords

    • Diet
    • quality of life
    • renal
    • qualitative
    • patient and public involvement

    ASJC Scopus subject areas

    • Medicine (miscellaneous)
    • Nutrition and Dietetics
    • Nephrology

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