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

Abstract

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. Qualitative semistructured interviews were undertaken in a UK teaching hospital with adults undergoing maintenance hemodialysis. Audio-recorded, transcribed interviews underwent thematic analysis. 34 adults (19 women, 15 men, and mean age 66.7±10.9years) 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. 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.