Objective: The standard potassium(K) bath used at many haemodialysis units is K2 (no K added to dialysate). If a patient’s serum K is too low, potassium is added to the dialysate to increase it to a K3. We aimed to reduce the use of potassium additives, without compromising the patients’ potassium status.

Method: In July 2008, 11 patients at our Renal Unit on K3 baths, were assessed for suitability to reduce their K bath. 9 patients were deemed clinically appropriate and were advised in a quantified manner by the dietitian, on increasing foods in their diet, that were moderate to high in potassium. K baths were then reduced from 3 to 2 and follow-up blood tests were performed to monitor the patients’ serum K. If subsequent results were low, further dietetic review took place.

Results: In 3 months, 7 of the original 9 patients included in the project, were stable on K2 baths. Patients were able to enjoy a wider variety of foods, which provide improved nutrition and enjoyment of food. A saving of $3500 per annum for the Renal Unit was also achieved as each K additive costs $3.20.

Conclusion: A multi-disciplinary approach can be taken to optimise potassium regulation in haemodialysis patients. At the commencement of haemodialysis or at any later period, dietary manipulation of potassium can be trialled, before altering potassium dialysate additives, to maintain a safe serum K in people undergoing haemodialysis, thereby allowing patients a less restrictive diet and reducing costs.