Study · Nutrients · 2021Conflicts declared

Potassium chloride in bread and kidney disease diets

What it found

In a dietary modelling study, replacing some of the sodium in bread with potassium chloride pushed about one third of people with chronic kidney disease over the recommended daily potassium limit.

The work used survey data from 12,152 Australians, not a real-world trial.

What they found

Studies in people

Potassium limit exceeded

At baseline, 31% of people with chronic kidney disease were already over the recommended daily potassium limit. With potassium chloride substitution, this rose to 31.8% at 20%, 32.6% at 30% and 33% at 40% replacement.

Sodium intake fell

Replacing sodium with potassium chloride in bread cut daily sodium intake by about 5% (113.5 mg per day). The authors call this a significant decrease.

Potassium from bread

Bread and bread products provided 4.29% of daily potassium for people with chronic kidney disease at baseline. This rose to 5.91% when 40% of the sodium was replaced with potassium chloride.

Higher potassium in CKD

People with chronic kidney disease already took in more potassium than the larger group, even before any substitution. Their daily potassium was 2351.8 mg compared with 2288.6 mg for all participants.

Bread eaten more often

A greater percentage of people with chronic kidney disease reported eating bread or bread-based products on both survey days compared with all participants (43.5% vs 36.5%).

What the authors conclude

“KCl substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium.”
Morrison R, Stanford J, Lambert K, 2021

Also in their conclusions

  • They say that potassium chloride substitution in staple foods like bread can have serious and potentially fatal consequences for people who need to restrict dietary potassium.
  • They call for improved food labelling so consumers can avoid excessive potassium.
  • They recommend that widespread sodium replacement with potassium chloride requires mandatory food labelling.

How it was done

Food makers are swapping potassium chloride for sodium chloride in foods like bread to cut sodium. The authors wanted to see what this would mean for people with chronic kidney disease, who often need to limit potassium.

They used dietary data from the 2011-2012 National Nutrition and Physical Activity Survey, covering 12,152 people, including 154 with chronic kidney disease. They modelled replacing 20%, 30% and 40% of the sodium chloride in bread and bread-based products with potassium chloride, then calculated daily potassium intakes.

What it can’t tell you

  • This was a dietary modelling study using survey data, not a real-world trial. It can show what might happen if potassium chloride were used, but not what actually happens when people eat such products.
  • The survey data are from 2011-2012 and may not reflect current food choices or potassium intakes.
  • The study only looked at bread and bread-based products, not other foods that might also contain added potassium chloride.

The paper

Title
Dietary Modelling to Explore the Impact of Potassium Chloride Replacement for Sodium in Bread for Adults with Chronic Kidney Disease
Type
Study
Evidence
Studies in people
Summarised from
Full text
Cite
Morrison R, Stanford J, Lambert K (2021). Dietary Modelling to Explore the Impact of Potassium Chloride Replacement for Sodium in Bread for Adults with Chronic Kidney Disease. Nutrients. doi:10.3390/nu13072472Free full textPubMed 34371980DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error