Correction of hyperkalemia in dogs with chronic kidney disease consuming commercial renal therapeutic diets by a potassium-reduced home-prepared diet

G. Segev, Andrea J Fascetti, L. P. Weeth, Larry D Cowgill

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Hyperkalemia occurs in dogs with chronic kidney disease (CKD). Objectives: (1) To determine the incidence of hyperkalemia in dogs with CKD, (2) to determine the proportion of hyperkalemic dogs that required modification of dietary potassium intake, (3) to evaluate the response to dietary modification. Methods: The hospital database was reviewed retrospectively to identify dogs with CKD and persistent (>5.3 mmol/L on at least 3 occasions) or severe (K ≥ 6.5 mmol/L) hyperkalemia while consuming a therapeutic renal diet. Records of dogs with hyperkalemia that were prescribed a home-prepared, potassium-reduced diet were evaluated further. Response was evaluated by changes in body weight, BCS, and serum potassium concentration. Results: One hundred and fifty-two dogs were diagnosed with CKD, of which 47% had ≥1 documented episode of hyperkalemia, 25% had ≥3 episodes of hyperkalemia, and 16% had ≥1 episodes of severe hyperkalemia (K > 6.5 mmol/L). Twenty-six dogs (17.2%) with CKD and hyperkalemia were prescribed a potassium-reduced, home-prepared diet. The potassium concentration of all hyperkalemic dogs on therapeutic diets (potassium content, 1.6 ± 0.23 g/1,000 kcal of metabolizable energy [ME]) was 6.5 ± 0.5 mmol/L but decreased significantly to 5.1 ± 0.5 mmol/L in 18 dogs available for follow-up in response to the dietary modification (0.91 ± 0.14 g/1,000 kcal of ME, P < 001). Potassium concentration normalized in all but 1 dog. Conclusions and Clinical Importance: Hyperkalemia is a potential complication of CKD. In a subset of CKD dogs, hyperkalemia can be associated with commercial renal diets and could restrict use of these diets. Appropriately formulated, potassium-reduced, diets are an effective alternative to correct hyperkalemia.

Original languageEnglish (US)
Pages (from-to)546-550
Number of pages5
JournalJournal of Veterinary Internal Medicine
Volume24
Issue number3
DOIs
StatePublished - May 2010

Fingerprint

hyperkalemia
diet therapy
Hyperkalemia
kidney diseases
Chronic Renal Insufficiency
Potassium
potassium
kidneys
Dogs
Diet
Kidney
dogs
diet
Therapeutics
Diet Therapy
metabolizable energy
Dietary Potassium
Body Weight Changes
body weight changes

Keywords

  • Angiotensin-converting enzyme
  • Canine
  • Home-cooked
  • Nutrition

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Correction of hyperkalemia in dogs with chronic kidney disease consuming commercial renal therapeutic diets by a potassium-reduced home-prepared diet",
abstract = "Background: Hyperkalemia occurs in dogs with chronic kidney disease (CKD). Objectives: (1) To determine the incidence of hyperkalemia in dogs with CKD, (2) to determine the proportion of hyperkalemic dogs that required modification of dietary potassium intake, (3) to evaluate the response to dietary modification. Methods: The hospital database was reviewed retrospectively to identify dogs with CKD and persistent (>5.3 mmol/L on at least 3 occasions) or severe (K ≥ 6.5 mmol/L) hyperkalemia while consuming a therapeutic renal diet. Records of dogs with hyperkalemia that were prescribed a home-prepared, potassium-reduced diet were evaluated further. Response was evaluated by changes in body weight, BCS, and serum potassium concentration. Results: One hundred and fifty-two dogs were diagnosed with CKD, of which 47{\%} had ≥1 documented episode of hyperkalemia, 25{\%} had ≥3 episodes of hyperkalemia, and 16{\%} had ≥1 episodes of severe hyperkalemia (K > 6.5 mmol/L). Twenty-six dogs (17.2{\%}) with CKD and hyperkalemia were prescribed a potassium-reduced, home-prepared diet. The potassium concentration of all hyperkalemic dogs on therapeutic diets (potassium content, 1.6 ± 0.23 g/1,000 kcal of metabolizable energy [ME]) was 6.5 ± 0.5 mmol/L but decreased significantly to 5.1 ± 0.5 mmol/L in 18 dogs available for follow-up in response to the dietary modification (0.91 ± 0.14 g/1,000 kcal of ME, P < 001). Potassium concentration normalized in all but 1 dog. Conclusions and Clinical Importance: Hyperkalemia is a potential complication of CKD. In a subset of CKD dogs, hyperkalemia can be associated with commercial renal diets and could restrict use of these diets. Appropriately formulated, potassium-reduced, diets are an effective alternative to correct hyperkalemia.",
keywords = "Angiotensin-converting enzyme, Canine, Home-cooked, Nutrition",
author = "G. Segev and Fascetti, {Andrea J} and Weeth, {L. P.} and Cowgill, {Larry D}",
year = "2010",
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doi = "10.1111/j.1939-1676.2010.0488.x",
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volume = "24",
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T1 - Correction of hyperkalemia in dogs with chronic kidney disease consuming commercial renal therapeutic diets by a potassium-reduced home-prepared diet

AU - Segev, G.

AU - Fascetti, Andrea J

AU - Weeth, L. P.

AU - Cowgill, Larry D

PY - 2010/5

Y1 - 2010/5

N2 - Background: Hyperkalemia occurs in dogs with chronic kidney disease (CKD). Objectives: (1) To determine the incidence of hyperkalemia in dogs with CKD, (2) to determine the proportion of hyperkalemic dogs that required modification of dietary potassium intake, (3) to evaluate the response to dietary modification. Methods: The hospital database was reviewed retrospectively to identify dogs with CKD and persistent (>5.3 mmol/L on at least 3 occasions) or severe (K ≥ 6.5 mmol/L) hyperkalemia while consuming a therapeutic renal diet. Records of dogs with hyperkalemia that were prescribed a home-prepared, potassium-reduced diet were evaluated further. Response was evaluated by changes in body weight, BCS, and serum potassium concentration. Results: One hundred and fifty-two dogs were diagnosed with CKD, of which 47% had ≥1 documented episode of hyperkalemia, 25% had ≥3 episodes of hyperkalemia, and 16% had ≥1 episodes of severe hyperkalemia (K > 6.5 mmol/L). Twenty-six dogs (17.2%) with CKD and hyperkalemia were prescribed a potassium-reduced, home-prepared diet. The potassium concentration of all hyperkalemic dogs on therapeutic diets (potassium content, 1.6 ± 0.23 g/1,000 kcal of metabolizable energy [ME]) was 6.5 ± 0.5 mmol/L but decreased significantly to 5.1 ± 0.5 mmol/L in 18 dogs available for follow-up in response to the dietary modification (0.91 ± 0.14 g/1,000 kcal of ME, P < 001). Potassium concentration normalized in all but 1 dog. Conclusions and Clinical Importance: Hyperkalemia is a potential complication of CKD. In a subset of CKD dogs, hyperkalemia can be associated with commercial renal diets and could restrict use of these diets. Appropriately formulated, potassium-reduced, diets are an effective alternative to correct hyperkalemia.

AB - Background: Hyperkalemia occurs in dogs with chronic kidney disease (CKD). Objectives: (1) To determine the incidence of hyperkalemia in dogs with CKD, (2) to determine the proportion of hyperkalemic dogs that required modification of dietary potassium intake, (3) to evaluate the response to dietary modification. Methods: The hospital database was reviewed retrospectively to identify dogs with CKD and persistent (>5.3 mmol/L on at least 3 occasions) or severe (K ≥ 6.5 mmol/L) hyperkalemia while consuming a therapeutic renal diet. Records of dogs with hyperkalemia that were prescribed a home-prepared, potassium-reduced diet were evaluated further. Response was evaluated by changes in body weight, BCS, and serum potassium concentration. Results: One hundred and fifty-two dogs were diagnosed with CKD, of which 47% had ≥1 documented episode of hyperkalemia, 25% had ≥3 episodes of hyperkalemia, and 16% had ≥1 episodes of severe hyperkalemia (K > 6.5 mmol/L). Twenty-six dogs (17.2%) with CKD and hyperkalemia were prescribed a potassium-reduced, home-prepared diet. The potassium concentration of all hyperkalemic dogs on therapeutic diets (potassium content, 1.6 ± 0.23 g/1,000 kcal of metabolizable energy [ME]) was 6.5 ± 0.5 mmol/L but decreased significantly to 5.1 ± 0.5 mmol/L in 18 dogs available for follow-up in response to the dietary modification (0.91 ± 0.14 g/1,000 kcal of ME, P < 001). Potassium concentration normalized in all but 1 dog. Conclusions and Clinical Importance: Hyperkalemia is a potential complication of CKD. In a subset of CKD dogs, hyperkalemia can be associated with commercial renal diets and could restrict use of these diets. Appropriately formulated, potassium-reduced, diets are an effective alternative to correct hyperkalemia.

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