Association of low potassium diet and folic acid deficiency in patients with CKD

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Abstract

Background: Most of the folic acid sources are rich also in potassium. Patients with chronic kidney disease (CKD) usually receive a low potassium diet. We investigated the possibility of an association between low potassium diet and folic acid deficiency. Methods: In total, 128 CKD patients participated in this cross-sectional study. Sixty-four patients with CKD grades 1 and 2 were on an unrestricted potassium diet when enrolled in the study, and 64 patients with CKD grades 3 and 4 had received instructions to restrict their intake of potassium at least 6 months before enrollment in the study. Subjects were evaluated for daily intake of folic acid (DI FA), daily intake of potassium (DI K), and serum folic acid levels (S FA). Results: DI FA correlated with the estimated glomerular filtration rate, the DI K, and the S FA (P<0.001). S FA correlated with the estimated glomerular filtration rate (P<0.001). Mean DI FA and mean S FA were lower among patients with CKD grades 3 and 4 than among those with CKD grades 1 and 2 (P<0.001). The mean DI FA in patients with folic acid deficiency was lower than that in those with S FA ≥7.1 nmol/L (P<0.001). There was lower S FA and threefold greater frequency of folic acid deficiency among patients with CKD grades 3 and 4 who had received instructions to restrict their intake of potassium than among patients with CKD grades 1 and 2 who were on an unrestricted potassium diet. Conclusion: A potassium-restricted diet offered to patients with CKD grades 3 and 4 may be associated with folic acid deficiency. Serum levels of folic acid should be investigated before starting potassium restriction in patients with CKD grades 3 and 4, in order to identify individuals with folic acid deficiency or with marginal serum levels who should receive folic acid replacement therapy.

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APA

Hassan, K. (2015). Association of low potassium diet and folic acid deficiency in patients with CKD. Therapeutics and Clinical Risk Management, 11, 821–827. https://doi.org/10.2147/TCRM.S83751

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