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.

中文翻译：

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慢性肾病血清钾饮食管理经验：对维持性血液透析英国成年人的访谈

客观的

肾病患者的饮食钾限制很复杂，可能会降低生活质量。然而，关于这种影响的细节很少。因此，我们试图探索患者对遵循低钾饮食所经历的影响的看法，为临床实践和研究提供信息。

设计和方法

在英国一家教学医院对接受维持性血液透析的成年人进行了定性半结构式访谈。对录音、转录的采访进行了专题分析。

结果

34 名患有慢性肾病 (CKD) 的成人（19 名女性，15 名男性，平均年龄 66.7 ± 10.9 岁）参与了研究。我们的分析确定了三个带有副主题的主题：“我现在还能吃什么？”；“我显然与众不同”；“食物在社交上可能很尴尬”，还有一个外围主题：“钱不是长在树上的。” 在接受饮食限制时遇到的实际困难意味着测试建议并尝试低钾和高钾食物，以找到合理的折衷方案，尽管担心他们可能会因摄入过多钾而死亡。与食品供应商的互动依赖于预先存在的关系，并以牺牲他们的饮食需求为代价来维持这些关系。在餐厅获得饮食要求通常会导致冲突，而不太关心与餐厅中的人保持关系。一些人遇到了经济困难，因此决定优先考虑家庭需求而不是他们自己的饮食需求。

结论

低钾饮食会带来实际和社会心理后果，严重影响 CKD 患者。肾脏健康专业人员应该为低钾饮食的人提供更多支持。关于 CKD 膳食钾需求的公众教育，特别是在食品服务行业，以提高认识，可能是值得的干预措施。