Diuretic-Induced Hypokalemia and the Use of Salt Substitutes Hypokalemia in association with diuretic therapy is common. The potassium supplements frequently used to correct hypokalemia are costly and may cause side effects. One possible alternative to potassium supplements is the use of salt substitutes. Salt substitutes cost one-tenth as much as potassium supplements and can provide equivalent amounts of pottasium. Hueston conducted a clinical trial of the effectiveness, safety and patient acceptance of salt substitutes.
Ten patients with controlled hypertension who were taking a prescription potassium replacement for diuretic-induced hypokalemia agreed to use a salt substitute instead of their usual potassium supplement for a six-week period. Serum potassium levels were monitored every two weeks. At the conclusion of the trial, a questionnaire was completed by the patients to assess side effects and patient satisfaction.
The salt substitutes was very effective in maintaining potassium levels in the normal range. A few side effects were reported, but none was severe enough to warrant discontinuation. Patient satisfaction with the salt substitutes was low because of its taste. Eight of the ten patients discontinued using the salt substitutes and returned to their potassium supplement regimens, despite the higher cost. One patient preferred the salt substitute, and one patient chose to continue using the salt substitute because of its low cost. The two patients who continued to use the salt substitute reported no side effects at one-year follow-up.
The author believes that salt substitutes are safe, effective and economical alternatives to potassium supllements. However, poor patient acceptance because of the taste was a limiting factor in this series of patients. (Journal of Family, Practice, December 1989, vol. 29, p. 623.)
COPYRIGHT 1990 American Academy of Family Physicians
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