Tight Control of Dietary Potassium in Renal Insufficiency and Hemodialysis: Understanding the Difference
Patients with renal insufficiency and hemodialysis require different approaches to dietary potassium control. Renal insufficiency is typically due to a decrease in the glomerular filtration rate (GFR) and is associated with an increased risk of hyperkalemia. As such, patients with renal insufficiency require tighter control of dietary potassium intake to prevent hyperkalemia and other complications. On the other hand, hemodialysis patients may have normal GFR and may not be at risk of hyperkalemia. However, due to the high solute load and fluid shifts associated with hemodialysis, these patients still require tight control of dietary potassium intake to prevent dialysis-associated complications, such as intradialytic hypotension and volume overload (Charytan et al., 2016). Sodium has a direct impact on blood pressure (BP) due to its effect on fluid and electrolyte balance. Sodium intake can increase BP by increasing intravascular volume, which in turn increases cardiac output and systemic vascular resistance (SVR). In addition, sodium also affects BP indirectly through its effect on the renin-angiotensin-aldosterone system (RAAS). The RAAS is an important hormonal system that is activated in response to decreased sodium, resulting in increased levels of aldosterone and vasopressin, which can further increase BP (Dahl and Hinderliter, 2017). Cont…
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