Potassium Research
48 peer-reviewed studies · Evidence score: 9/10
Spironolactone in patients on chronic haemodialysis at high risk of adverse cardiovascular outcomes (ALCHEMIST): a multicentre, double-blind, randomised, placebo-controlled trial and updated meta-analysis
Rossignol P et al. • Lancet (London, England) (2025)
In patients with kidney failure on haemodialysis and with high risk of adverse cardiovascular outcomes, spironolactone did not reduce the incidence of major cardiovascular events.
- In patients with kidney failure on haemodialysis and with high risk of adverse cardiovascular outcomes, spironolactone did not reduce the incidence of major cardiovascular events.
- The updated meta-analysis shows that mineralocorticoid receptor antagonists did not reduce all-cause or cardiovascular mortality.
- Therefore, off-label use of spironolactone in this setting is not supported by available evidence.
Comparative Efficacy and Safety of Potassium-Competitive Acid Blocker-Based Dual, Triple, and Quadruple Regimens for First-Line Helicobacter pylori Infection Treatment: A Systematic Review and Network Meta-Analysis
Rokkas T et al. • The American journal of gastroenterology (2025)
The comparative effectiveness ranking showed that P-CAB dual therapy regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.
- The surface under the cumulative ranking area values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4, and 16.3, respectively.
- Published in The American journal of gastroenterology (2025)
- Further research warranted to confirm findings
The effects of antidepressants on cardiometabolic and other physiological parameters: a systematic review and network meta-analysis
Pillinger T et al. • Lancet (London, England) (2025)
We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters.
- We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters.
- Treatment guidelines should be updated to reflect differences in physiological risk, but choice of antidepressant should be made on an individual basis, considering clinical presentation and preferences of patients, carers, and clinicians.
- Further research warranted to confirm findings
Effect of changes in potassium intake on blood pressure: a dose–response meta-analysis of randomized clinical trials (2000–2024)
Filippini T et al. • Clinical Kidney Journal (2024)
Boosting potassium intake can play a critical role in improving BP control and lowering cardiovascular risk.
- Dose-response analysis of RCTs from 2000-2024
- Significant blood pressure reductions
- Benefits most pronounced in hypertensive populations
Treatment of Helicobacter pylori with potassium competitive acid blockers: A systematic review and meta-analysis
Kanu JE et al. • World journal of gastroenterology (2024)
VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H. pylori, positioning it as a highly effective first-line regimen.
- However, no significant difference was found between tegoprazan (TPZ) triple therapy and PPI triple therapy in both RCTs and observational studies (RR = 1.04, 95%CI: 0.93-1.16, P = 0.5) and (RR = 1.03, 95%CI: 0.97-1.10, P = 0.3), respectively.
- VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H. pylori, positioning it as a highly effective first-line regimen.
- Additionally, TPZ-based triple therapy was non-inferior to classical PPI triple therapy.
Efficacy and safety of isotonic versus hypotonic intravenous maintenance fluids in hospitalized children: an updated systematic review and meta-analysis of randomized controlled trials
Amer BE et al. • Pediatric nephrology (Berlin, Germany) (2024)
Isotonic IV-MFT was superior to the hypotonic one in reducing the risk of iatrogenic hyponatremia in hospitalized children.
- Isotonic IV-MFT significantly increased the risk of hypernatremia in neonates (RR = 3.74, 95% CI [1.42, 9.85], P = 0.008).
- In addition, it significantly increased serum creatinine at ≤ 24 h (MD = 0.89, 95% CI [0.84, 0.94], P < 0.00001) and decreased blood pH (MD = -0.05, 95% CI [-0.08 to -0.02], P = 0.0006).
- Isotonic IV-MFT was superior to the hypotonic one in reducing the risk of iatrogenic hyponatremia in hospitalized children.
Acid-suppressive drugs: A systematic review and network meta-analysis of their nocturnal acid-inhibitory effect
Zou S et al. • Pharmacotherapy (2024)
This is the first study to compare the effect of ASDs on inhibiting nocturnal acid breakthrough.
- This is the first study to compare the effect of ASDs on inhibiting nocturnal acid breakthrough.
- Overall, in terms of nocturnal acid-inhibitory effect, vonoprazan and tegoprazan had an advantage against other regimens including H2RAs, isomer PPIs, traditional PPIs, AHB, and new PPIs.
- Further research warranted to confirm findings
Sex-specific associations between sodium and potassium intake and overall and cause-specific mortality: a large prospective U.S. cohort study, systematic review, and updated meta-analysis of cohort studies
Gan L et al. • BMC medicine (2024)
Our study demonstrates significant positive associations between daily sodium intake (within the range of sodium intake between 2,000 and 7,500 mg/d), the sodium-potassium ratio, and risk of CVD and overall mortality, with women having stronger sodium-potassium ratio-mortality associations than men, and with the meta-analysis providing compelling support for the CVD associations.
- Meta-analysis examining Potassium efficacy
- Published in BMC medicine (2024)
- Further research warranted to confirm findings
Comparative efficacy of treatments for molluscum contagiosum: A systematic review and network meta-analysis
Chao YC et al. • Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (2023)
Ingenol mebutate, cryotherapy, podophyllotoxin, and KOH were more effective than the other interventions in achieving complete clearance, but safety concerns regarding ingenol mebutate have recently been reported.
- Ingenol mebutate, cryotherapy, podophyllotoxin, and KOH were more effective than the other interventions in achieving complete clearance, but safety concerns regarding ingenol mebutate have recently been reported.
- Due to the possibility of spontaneous resolution, observation is also justified for asymptomatic infection.
- Factors including adverse effects, cost, patient preference, and medical accessibility should be considered.
Safety and efficacy of new potassium binders on hyperkalemia management in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials
Carvalho PEP et al. • Clinical research in cardiology : official journal of the German Cardiac Society (2023)
The use of new potassium binders Patiromer or SZC in patients with HF at risk for hyperkalemia increased the rates of medical therapy optimization with renin-angiotensin-aldosterone inhibitors and reduced the incidence of hyperkalemia, at the cost of an increased prevalence of hypokalemia.
- A total of 1432 patients from 6 RCTs were included, of whom 737 (51.5%) patients received potassium binders.
- In patients with HF, potassium binders increased the use of renin-angiotensin-aldosterone inhibitors (RR 1.14; 95% CI 1.02-1.28; p = 0.021; I2 = 44%) and reduced the risk of hyperkalemia (RR 0.66; 95% CI 0.52-0.84; p < 0.001; I2 = 46%).
- The risk of hypokalemia was significantly increased in patients treated with potassium binders (RR 5.61; 95% CI 1.49-21.08; p = 0.011; I2 = 0%).
Thiazide diuretics alone or combined with potassium-sparing diuretics to treat hypertension: a systematic review and network meta-analysis of randomized controlled trials
Martins VM et al. • Journal of hypertension (2023)
Thiazides with potassium-sparing diuretics are associated with increased BP-lowering efficacy compared with thiazides alone while minimizing hypokalaemia and hyperglycaemia.
- Two hundred and seventy-six double-blind RCTs involving 58 807 participants (mean age: 55 years; 45% women) were included.
- All treatment groups were more effective than placebo in lowering BP, with mean differences (MDs) of change from baseline ranging from -7.66 mmHg [95% credible interval (95% CrI), -8.53 to -6.79] for T- to -12.77 mmHg (95% CrI, -15.22 to -10.31) for T+PS-.
- Thiazides with potassium-sparing diuretics are associated with increased BP-lowering efficacy compared with thiazides alone while minimizing hypokalaemia and hyperglycaemia.
A comparison of efficacy and safety of potassium-competitive acid blocker and proton pump inhibitor in gastric acid-related diseases: A systematic review and meta-analysis
Simadibrata DM et al. • Journal of gastroenterology and hepatology (2022)
Vonoprazan is superior to PPI in first-line H. pylori eradication and erosive esophagitis but non-inferior in other gastric acid-related diseases.
- The RRs for the healing of erosive esophagitis with Vonoprazan versus PPI were 1.09 (95% confidence interval [CI] 1.03-1.14), 1.03 (95% CI 1.00-1.07), and 1.02 (95% CI 1.00-1.05) in Weeks 2, 4, and 8, respectively.
- The pooled eradication rates of H. pylori were significantly higher in Vonoprazan versus PPI first-line treatment (RR 1.13; 95% CI 1.04-1.22).
- The overall RR of TEAEs with Vonoprazan versus PPI was 1.08 (95% CI 0.89-1.31).
Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials
Filippini T et al. • Journal of the American Heart Association (2020)
U-shaped relationship between potassium excretion and BP levels observed.
- 32 eligible trials analyzed
- Optimal dose around 30 mmol/d difference
- Effect weakens above 80 mmol/d difference
Potassium intake and blood pressure: meta-analysis
Aburto NJ et al. • BMJ (2013)
Increased potassium intake significantly reduces blood pressure and stroke risk.
- 3.5 mmHg reduction in systolic BP
- 24% reduction in stroke risk
- No adverse effects on kidney function in healthy adults
Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis
Jessen MK et al. • Resuscitation (2025)
Evidence supports treatment with insulin in combination with glucose, inhaled or intravenous sal-butamol, or the combination.
- Evidence supports treatment with insulin in combination with glucose, inhaled or intravenous sal-butamol, or the combination.
- No evidence supporting a clinical effect of calcium or bicarbonate for hyperkalaemia was identified.
- Further research warranted to confirm findings
Oral potassium supplementation for management of essential hypertension: A meta-analysis
Poorolajal J et al. • PLOS ONE (2017)
Potassium supplementation decreased systolic BP by 4.48 mmHg and diastolic by 2.96 mmHg.
- Systolic BP reduction of 4.48 mmHg
- Diastolic BP reduction of 2.96 mmHg
- Greater effect with higher sodium intake at baseline
Potassium binders for chronic hyperkalaemia in people with chronic kidney disease
Natale P et al. • The Cochrane database of systematic reviews (2020)
Evidence supporting clinical decision-making for different potassium binders to treat chronic hyperkalaemia in adults with CKD is of low certainty; no studies were identified in children.
- Patiromer or sodium zirconium cyclosilicate may make little or no difference to death (any cause) (4 studies, 688 participants: RR 0.69, 95% CI 0.11, 4.32; I2 = 0%; low certainty evidence) in CKD.
- Potassium binders may lower serum potassium levels (at the end of treatment) (3 studies, 277 participants: MD -0.62 mEq/L, 95% CI -0.97, -0.27; I2 = 92%; low certainty evidence) in CKD and HD.
- Potassium binders had uncertain effects on constipation (4 studies, 425 participants: RR 1.58, 95% CI 0.71, 3.52; I2 = 0%; low certainty evidence) in CKD.
Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension
Fu J et al. • Journal of the American Heart Association (2020)
Aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing-control, meditation and low-calorie diet also have obvious effects on BP reduction.
- Among overweight and obese participants, low-calorie diet and low-calorie diet plus exercise could lower more BP than exercise.
- Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension.
- Aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing-control, meditation and low-calorie diet also have obvious effects on BP reduction.
Non-prescription (OTC) oral analgesics for acute pain - an overview of Cochrane reviews
Moore RA et al. • The Cochrane database of systematic reviews (2015)
There is a body of reliable evidence about the efficacy of some of the most commonly available drugs and doses widely available without prescription.
- Combinations of ibuprofen plus paracetamol had success rates of almost 70%, with dipyrone 500 mg, fast acting ibuprofen formulations 200 mg and 400 mg, ibuprofen 200 mg plus caffeine 100 mg, and diclofenac potassium 50 mg having success rates above 50%.
- Paracetamol and aspirin at various doses had NNT values of 3 or above, and success rates of 11% to 43%.
- There is a body of reliable evidence about the efficacy of some of the most commonly available drugs and doses widely available without prescription.
Global mean potassium intake: a systematic review and Bayesian meta-analysis
Reddin C et al. • European journal of nutrition (2023)
Global mean potassium intake (2.25 g/day) falls below current guideline recommended intake level of > 3.5 g/day, with only 14% (95% CI 11-17%) of the global population achieving guideline-target mean intake.
- Approximately 31% (95% CI, 30-41%) of global population included have an estimated potassium intake > 2.5 g/day, with 14% (95% CI 11-17%) above 3.5 g/day.
- Global mean potassium intake (2.25 g/day) falls below current guideline recommended intake level of > 3.5 g/day, with only 14% (95% CI 11-17%) of the global population achieving guideline-target mean intake.
- There was considerable regional variation, with lowest mean potassium intake reported in Asia, and highest intake in Eastern and Western Europe.