Dialysis trial tests potassium binder as a way to loosen diet limits
A randomized trial enrolled adults on maintenance hemodialysis with elevated pre-dialysis potassium. Adding sodium zirconium cyclosilicate to nutrition counseling improved diet-related quality of life and lowered potassium more than counseling alone. The binder group also avoided rescue treatment during the eight-week study, with no serious treatment-related harms reported.
The trial was multicenter, randomized, open-label, and parallel-group. It enrolled adults on thrice-weekly maintenance hemodialysis whose pre-dialysis potassium was 5.5 to under 6.5 mEq/L. Participants received either sodium zirconium cyclosilicate plus standardized nutrition counseling or counseling alone for eight weeks. The main analysis covered 183 patients.
Beyond potassium control, exploratory findings suggested more fruit consumption without higher total dietary potassium, plus gains in some kidney-disease quality-of-life domains. No serious treatment-related adverse events or deaths were reported. The results are scheduled for presentation at ASN Kidney Week 2026.
For adults on maintenance hemodialysis, a potassium binder added to nutrition counseling could ease daily food restrictions and may improve diet-related quality of life, potentially reducing the burden on patients and caregivers. Clinicians and dietitians may gain another option when counseling alone feels restrictive, though access, cost, and long-term outcomes would shape real-world impact. The findings may also encourage care teams to assess treatment by patient burden as well as potassium levels.