An interventional study of Potassium Chloride and Potassium Citrate in Renal Insufficiency, Chronic, Potassium Depletion and Hypertension, sponsored by Erasmus Medical Center. Active, not recruiting at 4 sites in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-10.
Sponsored by Erasmus Medical Center · Not applicable, Interventional, and Treatment
The current high-sodium, low-potassium diet contributes to the high prevalence of high blood pressure (hypertension). Indeed, the anti-hypertensive effects of potassium supplementation are well-established. Hypertension is even more prevalent and resistant in patients with chronic kidney disease (CKD) and contributes to further decline in kidney function. Four recent epidemiological studies (published 2014 - 2016) showed that higher dietary potassium intake was associated with better renal outcomes. All studies recommended an intervention study with potassium supplementation in patients with CKD, but this has not been performed. The aim of this study is to study the renoprotective effect of potassium supplementation in patients with CKD (stage 3b or 4, i.e. estimated glomerular filtration rate [eGFR] 15 - 45 ml/min/1.73 m2).
Exclusion Criteria:
Placebo
Dietary Supplement: Placebo
Experimental Arm 1 - Rationale is that most evidence for a positive effect of potassium comes from studies using potassium chloride
Dietary Supplement: Potassium Chloride
Experimental Arm 2 - Rationale for citrate is that recent evidence indicates that alkali treatment may also be renoprotective.
Dietary Supplement: Potassium Citrate
Two potassium supplements with varying anions.
Potassium Citrate
Placebo
Difference in estimated glomerular filtration rate (eGFR)
Time frame: Two years
≥ 30% decrease in eGFR
Time frame: Two years
Slope analysis (change in eGFR in ml/min/1.73 m2/year)
Time frame: Two years
Doubling in serum creatinine or kidney failure (CKD stage 5 or start of kidney replacement therapy)
Time frame: Two years
Progression to next CKD or albuminuria class
Time frame: Two years
Ambulatory (24-hour) blood pressure
Time frame: Two years
Spot urine albumin to creatinine ratio (UACR)
Time frame: Two years
Cardiovascular event
Coronary heart disease death, fatal myocardial infarction, fatal stroke and other cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, unstable angina, resuscitated cardiac arrest
Time frame: Two years
All-cause mortality
Time frame: Two years
Incidence of hyperkalemia
Time frame: Two years
NT-pro-BNP
Volume marker 1
Time frame: Two years
Bioimpedance measures
Volume marker 2
Time frame: Two years
Pulse-wave velocity
Cardiovascular marker 1
Time frame: Two years
High-sensitive CRP
Cardiovascular marker 2
Time frame: Two years
Effects of 2-week KCl supplementation on plasma potassium (mmol/l)
Run-in outcome 1
Time frame: Two weeks
Incidence of Hyperkalemia after 2-week KCl supplementation
Run-in outcome 2
Time frame: Two weeks
Effects of 2-week KCl supplementation on office blood pressure (mmHg)
Run-in outcome 3
Time frame: Two weeks
Plan to share: Undecided
This study is active, not recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
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Erasmus Medical Center