Are Salt Alternatives Dangerous for People With Kidney Disease?

Why are kidney disease patient-advocacy groups on high alert after the newly proposed FDA rule which would allow food producers to replace table salt with a potassium-based salt alternative?

According to the Food and Drug Administration of the USA, the rule is a public health measure aimed at lowering the amount of added sodium in foods.

However, kidney disease advocates are saying one of the proposed alternatives for table salt is potassium chloride, which possesses no negative threats towards the normal person but could risk the health of those suffering from chronic kidney disease.

So while they applauded the FDA’s attempt to cut-down on the levels of sodium in packaged foods, as captured in a statement they issued on August 8, they also added that, “We must balance population health goals and the acute needs of an already medically complex population.”

Kidney Disease Prevents the Body From Excreting Potassium

According to the Centre for Disease Control, an estimated 37 million adults, live with chronic kidney disease, a condition that disproportionately impacts people of color.

Also, the National Institutes of Health has claimed in a report that Black Americans make up roughly 13 percent of the U.S. population, but account for 35 percent of people with kidney failure. Hispanic Americans are also nearly 1.3 times more likely to develop kidney failure than non-Hispanic Americans, and the rate of kidney failure among this population has spiked up by 70 percent since the year 2000.

The advocacy groups are on high alert because people living chronic kidney disease,which includes those with kidney failure, do not excrete potassium normally. So if these sufferers eat high amounts of potassium, there could be an abnormal accumulation of the mineral in their blood. The group says this could trigger elevated levels of potassium in the blood which could lead to distressing health conditions like hyperkalemia, abnormal heart rhythms and sometimes sudden cardiac death.

“Given the very high estimates of those who are unaware they have compromised kidney function and the clinical consequences of hyperkalemia, adding ‘hidden potassium’ in the form of potassium chloride substitutes to the American diet is a risk that should not be taken,” the AAKP statement said.

Salt Substitutes May Lower the Risk of Cardiovascular Disease and Death

A published study in the New England Journal of Medicine in 2021 claimed people who use salt substitutes observe lower rates of stroke, major cardiovascular events, and death from any cause. The study was a randomized one and was aimed at testing the effects of salt versus a potassium-based salt substitute in 600 villages in rural China.

The study captured roughly 21,000 people who were all aged 60 or older, and nearly all had a history of stroke, hypertension, or both. However, one major setback of the study was that it did not capture people suffering from kidney diseases who were on medications that made them more susceptible to hyperkalemia.

Other experts like David Goldfarb, the clinical chief of nephrology at NYU Langone Health in New York City, who is in support of the directive also fear its potential impact on people living with chronic kidney disease and are on medications that make them more susceptible to high levels of potassium in blood.

“There’s a possibility that a modest amount of potassium would be safe for people with kidney disease, but there’s a border to that. The amount of potassium that could be used as a salt substitute is relatively small and not necessarily dangerous even to people with kidney disease,” he said.

Leave a Comment