Dietary potassium restriction in chronic kidney disease

An integrative narrative review of evidence, uncertainty and practice persistence Background: Dietary potassium restriction is a routine part of chronic kidney disease care and is commonly used to manage hyperkalaemia risk and support pharmacological treatment. Despite its long-standing use, uncertainty persists regarding whether dietary potassium restriction produces clinically meaningful benefits for serum potassium control or patient outcomes. Aim: To explore why dietary potassium restriction continues in routine chronic kidney disease practice despite low-certainty evidence for efficacy. Methods: Drawing on historical and contemporary evidence and guideline evolution, this study examines how biological plausibility, precautionary risk management and implementation norms sustain practice. Conclusions: Renal multidisciplinary teams must work within areas of uncertainty regarding potassium restrcition for patients with chronic kidney disease, clearly communicating rationale and limitations, while continuing to monitor emerging evidence.