| Summary: | In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; <i>p</i> = 0.16) and DBP (−0.70 mm Hg; <i>p</i> = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (<i>p</i> = 0.054) and −0.08 mm Hg for DBP (<i>p</i> = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (<i>p</i> = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD.
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