What is the significance of potassium (K) salt?

From the Guidelines

Potassium-enriched salt substitutes, with a composition of 75% sodium chloride and 25% potassium chloride, should be recommended to all patients with hypertension, unless they have advanced kidney disease, are using a potassium supplement, are using a potassium-sparing diuretic, or have another contraindication. This recommendation is based on the most recent and highest quality study, which found that potassium-enriched salt substitutes are an effective option for improving consumption levels and reducing blood pressure and the rates of cardiovascular events and deaths 1. The use of potassium-enriched salt substitutes has been shown to be beneficial in reducing blood pressure, particularly in patients consuming a high-sodium diet, and has been associated with a lower incidence of stroke and cardiovascular events.

Key Points

• Potassium is essential for proper muscle function, nerve transmission, and heart rhythm regulation
• Low potassium levels can cause muscle weakness, cramps, irregular heartbeat, and in severe cases, paralysis or dangerous cardiac arrhythmias
• Potassium-enriched salt substitutes can help reduce blood pressure and the rates of cardiovascular events and deaths
• Patients with advanced kidney disease, using a potassium supplement, using a potassium-sparing diuretic, or with another contraindication should not use potassium-enriched salt substitutes

Benefits of Potassium-Enriched Salt Substitutes

• Reduce blood pressure and the rates of cardiovascular events and deaths
• Improve consumption levels of potassium
• Can be used as a substitute for regular salt in cooking and at the table
• May be particularly beneficial for patients consuming a high-sodium diet

Important Considerations

• Patients with certain kidney conditions, taking potassium-sparing diuretics, or with high potassium levels should avoid potassium-enriched salt substitutes as they can cause dangerous hyperkalemia
• Potassium-enriched salt substitutes should be used under the guidance of a healthcare provider, particularly in patients with underlying medical conditions
• The use of potassium-enriched salt substitutes should be part of a comprehensive approach to managing hypertension, including lifestyle modifications and other evidence-based treatments 1.

From the FDA Drug Label

In patients with impaired mechanisms for excreting potassium, the administration of potassium salts can produce hyperkalemia and cardiac arrest. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic The use of potassium salts in patients with chronic renal disease, or any other condition which impairs potassium excretion, requires particularly careful monitoring of the serum potassium concentration and appropriate dosage adjustment

The significance of potassium (K) salt is that it can produce hyperkalemia and cardiac arrest in patients with impaired mechanisms for excreting potassium.

• Key points:
  • Potassium salts can cause potentially fatal hyperkalemia
  • Requires careful monitoring of serum potassium concentration
  • Needs appropriate dosage adjustment in patients with chronic renal disease or other conditions that impair potassium excretion 2

From the Research

Significance of Potassium (K) Salt

• Potassium is an essential electrolyte, with hypokalemia (low serum potassium levels) being a common electrolyte disturbance, observed in > 20% of hospitalized patients 3.
• Hypokalemia can lead to various symptoms, including muscle weakness, fatigue, and constipation, and can be life-threatening if left untreated 3, 4, 5.
• Potassium supplements and potassium-sparing diuretics can be used to treat hypokalemia, with the goal of maintaining serum potassium levels above 3.5 mmol/L 4, 5.
• Increasing dietary potassium intake can also be beneficial, although caution is needed in certain populations, such as the elderly and patients with renal impairment 4.
• The use of potassium-sparing diuretics in combination with non-potassium-retaining diuretics is not routinely recommended, unless the patient is at high risk of hypokalemia 4.

Clinical Implications

• Hypokalemia is associated with potentially severe complications, including arrhythmias, which necessitate careful monitoring and repletion with potassium 6, 5.
• Oral liquid potassium chloride is a commonly used treatment for hypokalemia, with immediate release formulations being preferred for inpatient use due to their rapid absorption and subsequent increase in serum potassium levels 6.
• Guidelines for potassium replacement therapy have been developed to provide a general approach to the prevention and treatment of hypokalemia, with the goal of maintaining serum potassium levels within a normal range 7.

Treatment Options

• Treatment options for hypokalemia include increased consumption of potassium-rich foods, the use of salt substitutes, medicinal potassium supplementation, and distal tubular (potassium-sparing) diuretics 4, 5.
• Potassium repletion requires substantial and prolonged supplementation, as small potassium deficits in serum can represent large body losses 3.
• The choice of treatment depends on the severity of the hypokalemia, as well as the presence of any underlying medical conditions or risk factors 3, 4, 5.