ClinicalTrials.gg
Not yet recruitingNCT06920914K-HANDLE CKDUpdated Oct 26, 2026

Effects of Minimally vs. Ultra-Processed Diets on Potassium (K) Handling in CKD

An interventional study of Low-potassium, ultra-processed diet and Low-potassium, minimally processed diet in Chronic Kidney Disease, sponsored by University of Alberta. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-26.

Sponsored by University of Alberta · Not applicable, Interventional, and Basic science

Updated Oct 26, 2026Start date movedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

What is this study about?

This clinical trial is designed to learn how potassium from different types of food affects blood potassium levels and overall health in people with chronic kidney disease (CKD, stages 3B-5).

People with CKD are often advised to avoid potassium-rich foods, even though fresh fruits and vegetables are important for good health. However, potassium in processed foods (such as packaged snacks and ready-made meals) may be absorbed differently than potassium from fresh foods.

This study will compare minimally processed vs. ultra-processed foods to determine how different sources of potassium affect potassium levels and help create better dietary recommendations for people with CKD.

What are the study goals?

The study will answer:

  • Does potassium from fresh foods (like fruits and vegetables) affect blood potassium differently than potassium from processed foods?
  • How does dietary potassium impact potassium absorption and excretion in people with CKD?

Researchers will compare the effects of four diets to understand how low and normal-potassium rich diets from fresh vs. processed foods influence:

  • Blood potassium levels
  • Body composition (muscle, fat, and fluid balance)
  • Vascular health

What will participants do?

Participants will follow four different 10-day diets over the course of the study. All food will be provided at no cost. These diets are:

  • Minimally processed with low-potassium content
  • Minimally processed with normal potassium content
  • Ultra-processed with with low-potassium content
  • Ultra-processed with normal potassium content

There will be 16-day breaks (washout period) between diets where participants return to their normal eating habits.

During the study, participants will:

  • Pick up prepared meals from the research center approximately 3 times per week.
  • Attend checkups for weight, blood pressure, and blood tests.
  • Provide urine samples to track potassium levels.
  • Wear a comfortable, cuff-free blood pressure monitor at home.
  • Keep a study journal to track diet, medications, and symptoms.
  • Complete questionnaires about diet satisfaction and health changes.
02

Conditions studied

  • Chronic Kidney Disease

Keywords

  • CKD
  • Chronic Kidney Disease
  • potassium
  • hyperkalemia
  • hyperkalaemia
  • minimally processed foods
  • ultra-processed foods
  • feeding trial
03

In context

Renal Insufficiency, Chronic

3,090 studies on the registry are indexed under Renal Insufficiency, Chronic; 698 are open to participants now.

This study's planned enrollment of 48 is below the median of 73 across 2,157 interventional studies indexed under Renal Insufficiency, Chronic.

Browse Renal Insufficiency, Chronic studies →

Lead sponsor

University of Alberta is the lead sponsor of 823 studies on the registry; 169 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 3 (60%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Participants aged ≥18 years living with stage 3B-5 CKD (estimated ≥ 15 mL/min/1.73m2) on conservative kidney management (not on dialysis).
  • Able and willing to follow a controlled feeding regimen, attend in-person visits, provide , and comply with study procedures.

Exclusion criteria

Exclusion Criteria:

General

  • Pregnant or lactating women.
  • Transitioning transgender individuals.
  • Individuals with strict dietary preferences (e.g., vegetarians, vegans) or allergies/intolerance that would preclude participation in the diet phases.

Kidney Function

  • Foreseen start of renal replacement therapy within the next 6 months.
  • Acute kidney injury in the past 3 months.
  • 2-year Kidney Failure Risk Equation > 40%.
  • Preemptive kidney transplant planned within the next 6 months.
  • History of kidney transplant.
  • Active glomerulonephritis. Comorbidities
  • Acute myocardial infarction or stroke within the past 6 months.
  • Active cancer.
  • Ileostomy, short bowel syndrome or inflammatory bowel disease.
  • \< 18.5 or ≥ 35.
  • Class III or IV congestive heart failure.
  • History of ventricular arrhythmia.
  • Major surgery within the past 3 months.
  • Active disease.
  • > 10% within the past 3 months.
  • Gastroparesis.
  • Chronic nausea and vomiting.
  • Intensive care unit admission within the past 3 months.
  • Significant psychiatric disease.
  • Uncontrolled blood pressure (above 160/100). Current Use of Medications/Supplements
  • Immunosuppressives.
  • Potassium binders.
  • Lithium.
  • Motility agents.
  • More than 2 medications that inhibit renal potassium excretion (e.g., angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, mineralocorticoid receptor antagonists).
  • Supplements known to influence potassium levels. Potassium-Related Conditions
  • Potassium > 5.5 mmol/L in more than 3 episodes within the past year.
  • Participants with genetic issues affecting potassium handling (e.g. Barter and Liddle syndrome) or other unique health conditions that could interfere with potassium handling.

Intervention-related Conditions

  • Fluid volume status or hypertension being actively managed. Other Factors
  • Documented non-adherence to medications or other therapeutic measures.
  • Use of tube feeding or parenteral nutrition.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
48 participants (estimated)

Study arms

  • Experimental
    Low-potassium, ultra-processed diet

    Participants in this group will follow a diet consisting of ultra-processed foods with restricted potassium content.

    Other: Low-potassium, ultra-processed diet

  • Experimental
    Normal potassium-rich, minimally processed diet

    Participants in this group will follow a diet consisting of minimally processed foods with a normal potassium content.

    Other: Normal potassium-rich, minimally processed diet

  • Experimental
    Normal potassium-rich, ultra-processed diet

    Participants in this group will follow a diet consisting of ultra-processed foods with a normal potassium content.

    Other: Normal potassium-rich, ultra-processed diet

  • Experimental
    Low-potassium, minimally processed diet

    Participants in this group will follow a diet consisting of minimally processed foods with restricted potassium content.

    Other: Low-potassium, minimally processed diet

Interventions

  • OtherLow-potassium, ultra-processed diet

    A diet restricted in potassium, primarily composed of industrially processed foods such as packaged snacks and processed meals.

  • OtherLow-potassium, minimally processed diet

    A diet restricted in naturally occurring potassium, primarily composed of fresh fruits, vegetables, whole grains, and other minimally processed foods.

  • OtherNormal potassium-rich, minimally processed diet

    A diet with normal potassium content, primarily composed of fresh fruits, vegetables, whole grains, and other minimally processed foods, rich in naturally occurring potassium, following a Mediterranean-style pattern.

  • OtherNormal potassium-rich, ultra-processed diet

    A diet with normal potassium content, primarily composed of industrially processed foods such as packaged snacks and processed meals

06

What researchers measure

Primary outcomes

  1. Fasting Serum Potassium Levels (mmol/L)

    This measure assesses the concentration of potassium in participants' blood after fasting overnight. Normal potassium levels typically range from 3.5 to 5.0 mmol/L.

    Time frame: Days 10, 36, 62, and 88.

Secondary outcomes

  1. Postprandial Whole-Blood Potassium Response (mmol/L)

    This measure examines changes in blood potassium levels after a standardized test meal. Blood samples are collected before the meal (baseline) and at regular intervals (15, 30, 60, 90, 120, 150, and 180 minutes) to calculate the area under the curve (AUC), which reflects the total potassium response over time.

    Time frame: 15, 30, 60, 90, 120, 150, 180 minutes post-meal at days 10, 36, 62, and 88.

  2. Potassium Bioavailability

    Potassium bioavailability is assessed by measuring the potassium content in 24-hour urine samples. This provides insights into how much potassium from the diet is absorbed and how much is excreted by the body.

    Time frame: Days 7-9, 33-35, 59-61, 85-87.

  3. Body Composition (kg)

    This measure estimates participants' fat mass and fat-free mass. Body composition is assessed using bioelectrical impedance analysis, which uses safe, low-level electrical currents to estimate tissue and fluid distribution. Results are reported in kilograms (kg).

    Time frame: Baseline and days 10, 36, 62, and 88.

  4. Body water (L)

    This measure evaluates fluid status, i which plays a role in potassium handling. Body water is estimated using bioelectrical impedance analysis, which uses safe, low-level electrical currents to estimate tissue and fluid distribution. Results are reported in liters for total, extracellular, and intracellular water.

    Time frame: Baseline and days 10, 36, 62, and 88.

  5. 24h blood pressure (mmHg)

    Systolic and diastolic blood pressure will be monitored for 24h.

    Time frame: Days 8-10, 34-36, 60-62, and 86-88.

  6. Dietary Satisfaction Questionnaire

    Self-administered questionnaire to provide feedback on the palatability, variety, and overall acceptability of the study-provided diets.

    Time frame: Days 10, 36, 62, and 88.

Other outcomes

  1. Hyperkalemic Events

    The frequency and severity of hyperkalemic events (serum potassium ≥5.5 mmol/L) are monitored throughout the study to ensure participant safety. Hyperkalemia episodes are recorded as a count of occurrences for each dietary phase. Evaluated at screening, baseline and Day 10 of each 10-day dietary phase.

    Time frame: Enrollment (Screening), baseline, and days 10, 36, 62, and 88.

  2. Potassium Content in Foods (mg)

    The potassium content of study-provided meals is measured to ensure accurate dietary potassium levels during each phase. Measured during the menu development phase and throughout the study.

    Time frame: Before enrollment and through study completion, an average of 3 years

  3. Phosphorus Content in Foods (mg)

    The phosphorus content of study-provided meals is measured to ensure accurate dietary phosphorus levels during each phase.Measured during the menu development phase and throughout the study.

    Time frame: Before enrollment and through study completion, an average of 3 years

  4. Sodium Content in Foods (mg)

    The sodium content of study-provided meals is measured to ensure accurate dietary sodium levels during each phase. Measured during the menu development phase and throughout the study.

    Time frame: Before enrollment and through study completion, an average of 3 years

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Picard K, Barreto Silva MI, Mager D, Richard C. Dietary Potassium Intake and Risk of Chronic Kidney Disease Progression in Predialysis Patients with Chronic Kidney Disease: A Systematic Review. Adv Nutr. 2020 Jul 1;11(4):1002-1015. doi: 10.1093/advances/nmaa027. PubMed 32191264 ↗
  • Picard K, Mager DR, Senior PA, Richard C. Potassium-Based Sodium Substitutes Impact the Sodium and Potassium Content of Foods. J Ren Nutr. 2025 Jan;35(1):64-71. doi: 10.1053/j.jrn.2024.05.010. Epub 2024 Jun 6. PubMed 38848804 ↗
  • Picard K. Potassium Additives and Bioavailability: Are We Missing Something in Hyperkalemia Management? J Ren Nutr. 2019 Jul;29(4):350-353. doi: 10.1053/j.jrn.2018.10.003. Epub 2018 Dec 19. PubMed 30579674 ↗
  • Picard K, Picard C, Mager DR, Richard C. Potassium content of the American food supply and implications for the management of hyperkalemia in dialysis: An analysis of the Branded Product Database. Semin Dial. 2024 Jul-Aug;37(4):307-316. doi: 10.1111/sdi.13007. Epub 2021 Jul 29. PubMed 34323307 ↗
  • Picard K RD BSc, Senior PA MBBS PhD FRCP(E) FRCP, Wilmott A BSc, Jindal K MD FRCPC, Richard C RD PhD, Mager DR RD PhD. Comparison of diet quality tools to assess nutritional adequacy for adults living with kidney disease. Can J Diet Pract Res. 2022 Dec 1;83(4):180-185. doi: 10.3148/cjdpr-2022-009. Epub 2022 May 3. PubMed 35503893 ↗
  • Picard K, Senior PA, Adame Perez S, Jindal K, Richard C, Mager DR. Low Mediterranean Diet scores are associated with reduced kidney function and health related quality of life but not other markers of cardiovascular risk in adults with diabetes and chronic kidney disease. Nutr Metab Cardiovasc Dis. 2021 May 6;31(5):1445-1453. doi: 10.1016/j.numecd.2021.02.002. Epub 2021 Feb 11. PubMed 33812736 ↗
  • Picard K, Griffiths M, Mager DR, Richard C. Handouts for Low-Potassium Diets Disproportionately Restrict Fruits and Vegetables. J Ren Nutr. 2021 Mar;31(2):210-214. doi: 10.1053/j.jrn.2020.07.001. Epub 2020 Aug 20. PubMed 32830022 ↗

Individual participant data

Plan to share: No — We have not yet finalized a plan for sharing individual participant data. The decision will depend on several factors, including participant consent, ethical approval, and institutional policies regarding data privacy and security. Future data sharing may be considered upon additional ethical review and participant consent.

09

Updates

1 registry update since Sep 25, 2026
Start date
Jul 1, 2026→Nov 1, 2026
Oct 26, 2026
Show all 1 update
  1. Oct 26, 2026
    Start date Jul 1, 2026→Nov 1, 2026
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06920914
Collaborators
Canadian Institutes of Health Research (CIHR)
Responsible party
Sponsor
First posted
Apr 10, 2025
Start date
Nov 1, 2026 (estimated)
Primary completion
Dec 1, 2027 (estimated)
Completion
Jun 1, 2028 (estimated)
Last update
Oct 26, 2026

Study contacts

Jenneffer Rayane Braga Tibaes, PhD
Contact
bragatib@ualberta.ca
7804929506
Caroline Richard, PhD
principal investigator · University of Alberta
Branko Braam, MD, PhD
principal investigator · University of Alberta

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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