An interventional study of Liberalized Potassium Diet and Low Potassium Diet in End Stage Kidney Disease (ESKD), Hemodialysis and Diet Intervention, sponsored by University of Ontario Institute of Technology. Not yet recruiting at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-19.
Sponsored by University of Ontario Institute of Technology · Not applicable, Interventional, and Treatment
People with end-stage kidney disease who receive hemodialysis are often told to strictly limit foods high in potassium, such as fruits, vegetables, legumes, nuts, and whole grains. This advice is intended to prevent high blood potassium levels (hyperkalemia), which can cause dangerous heart rhythm problems. However, these restrictions can make eating difficult, reduce diet quality, and lower quality of life. New research suggests that not all sources of potassium affect the body in the same way. Potassium added to highly processed foods is more easily absorbed than potassium naturally found in whole foods like fruits and vegetables. Large studies have found little evidence that eating potassium-rich whole foods increases blood potassium levels in people on dialysis. Clinical guidelines are beginning to shift, but no high-quality clinical trial has tested whether a more flexible, food-based approach is safe for people receiving hemodialysis. This study will compare two dietary approaches in 148 adults on hemodialysis: the usual low potassium diet and a "liberalized" potassium diet that encourages minimally processed foods while limiting highly processed foods with potassium additives. Participants will receive dietitian support and grocery assistance for 12 weeks. The investigators will closely monitor blood potassium levels to ensure safety. The investigators will also examine whether the liberalized diet is as safe as standard care, and whether it improves diet quality and quality of life. The investigators will also study factors that influence the participant's ability to follow the diet in real-world settings. If safe, this approach could reduce unnecessary food restrictions, improve diet quality, and enhance quality of life for people receiving hemodialysis, while maintaining patient safety.
Current potassium guidelines are highly restrictive, limit nutritious whole foods, and contribute to poor diet quality and reduced quality of life - yet largely rely on expert consensus rather than robust trial evidence. To our knowledge, LIBERATE K-HD would be the first RCT to evaluate the safety and sustainability of a liberalized potassium diet in patients receiving hemodialysis, directly addressing this critical evidence gap. By shifting the focus from strict potassium restriction to whole, minimally processed foods, this approach has the potential to simplify dietary advice, improve patient satisfaction, and enhance overall nutrition without increasing the risk of hyperkalemia. The results will directly inform clinical practice guidelines and renal dietetic practice, providing patient-centered evidence to support more flexible and equitabledietary recommendations. The behavioural and adherence data generated will further identify key determinants of sustained dietary change, including food literacy, self-efficacy, and dietary burden, offering guidance for behaviour change counselling and responsible implementation of a liberalized potassium approach in routine dialysis care. If effective, it could support more flexible and patient-centered dietary recommendations that improve both health outcomes and patient well-being.
2,108 studies on the registry are indexed under Kidney Failure, Chronic; 273 are open to participants now.
This study's planned enrollment of 148 is above the median of 57 across 1,569 interventional studies indexed under Kidney Failure, Chronic.
Browse Kidney Failure, Chronic studies →University of Ontario Institute of Technology is the lead sponsor of 9 studies on the registry; 2 are open to participants now.
Counted across the registry records on this site, refreshed daily.
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.
Exclusion Criteria
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.
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.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The intervention arm will liberalize their potassium intake to include fruits, vegetables, whole grains, nuts and legumes to achieve a daily potassium intake of \~2600-3000 mg per day.
Behavioral: Liberalized Potassium Diet
The control group will limit higher potassium fruits, vegetables, juices, and grains, to achieve a potassium intake of \~2000 mg/day.
Behavioral: Low Potassium Diet
For 12 weeks, the liberalized potassium diet group (n=74) will increase their intake of minimally processed foods that are higher in potassium, including fruits, vegetables, nuts, legumes and whole grains, while limiting highly processed foods rich in potassium (\>200 mg/serving) and potassium additives. The liberalized diet will provide \~2600-3000. Participants will also be counselled to use cooking techniques to reduce potassium in root vegetables. The liberalized diet will provide \~2600-3000 mg potassium daily, reflecting the mean potassium intake of Canadian adults. Participants will receive weekly individualized counselling (30-60 min) during the first 4 weeks, followed by sessions (weeks 8 \& 12), reflecting usual care and to reinforce adherence. During weeks 1 to 4, weekly home deliveries of groceries will be provided to support early dietary adoption and adherence. During weeks 5-12, participants will receive weekly grocery gift cards to reduce financial barriers and support.
The control group (n= 74) will limit higher potassium fruits, vegetables, juices, and grains, to achieve a potassium intake of \~2000 mg/day. Participants will also be counselled to use cooking techniques (e.g., double-boiling root vegetables) to reduce potassium. Consistent with standard of care, participants will receive monthly education by a registered dietitian using standardized low potassium education materials that contain lists of foods to 'choose' and 'avoid', and individualized to ensure budget, cooking abilities and patient preferences are addressed, as needed. Participants will receive weekly grocery gift cards for 12 weeks.
Time-averaged serum potassium
Time-averaged serum potassium is calculated as the mean of all weekly serum potassium measurements (mmol/L) for a participant over the defined study period, providing an integrated measure of potassium exposure over time and reducing the influence of isolated or transient fluctuations. Time-averaged serum potassium will be calculated as the area under the serum potassium-time curve divided by the total observation time.
Time frame: 12 weeks
Safety - Severe Hyperkalemia
Incidence of clinically meaningful, severe hyperkalemia defined as incident non-hemolyzed serum potassium \>6.5 mmol/L at any time point during the study.
Time frame: 12 weeks
Dietary Nutrient Intake
Dietary intake will be assessed using the Automated Self-Administered 24-Hour Dietary Recall (ASA24-Canada-2018). The ASA24-C is a self-administered, web-based recall available in English and French (\~25 minutes) that incorporates Canadian foods and the Canadian Nutrient File for nutrient analysis. From the ASA24-C, we will calculate mean nutrient intakes, including potassium (mg/day).
Time frame: 12 weeks
Health-Related Quality of Life
Health-related quality of life will be assessed using the EQ-5D-5L, a validated, widely used generic indicator of overall health status. It is comprised of five questions assessing the dimension of mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Time frame: 12 weeks
Diet Quality
From the ASA24-C, diet quality will be assessed using the Healthy Eating Food Index-2019 (HEFI-2019) score (0-80).
Time frame: 12 weeks
Ultra-processed food consumption
From the ASA24-C, ultra-processed food (UPF) consumption will be assessed using the NOVA classification system, which categorizes foods according to the degree of industrial processing. It will be calculated as the proportion of total energy intake from ultra-processed foods (% energy from UPF's, NOVA group 4)
Time frame: 12 weeks
Barriers and Facilitators to Adoption of Dietary Intervention
In both study groups, to compare the barriers and facilitators that impact behaviour change and real-world implementation of the dietary interventions, at baseline and after the dietary intervention, using a validated questionaire
Time frame: 12 weeks
Plan to share: Undecided
No publications or documents are linked to this record.
Start is estimated for Aug 2026; primary completion for Jul 2030, 47 months later.
Of 347 non-industry interventional studies with no phase under Kidney Failure, Chronic, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 47. This study's planned 47 months is above that.
Counting every sponsor, half of 425 studies reached it within 23 months; a quarter within 8 and three quarters within 46.
How these figures are worked out, and which studies are left out of them.
This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
University of Ontario Institute of Technology