16 individuals with hemodialysis-dependent end stage kidney disease will receive 16 days of a potassium-containing salt-substitute and 16 days of standard table salt in random order. There will be a 19 day wash out period between the salt-substitute and table salt periods. Potassium concentration will be measured bi-weekly prior to HD each week during intervention. The primary endpoint will be the change in potassium from baseline. Additional measurements will include assessment of dietary intake, ambulatory blood pressure, occurrence of peri-dialytic symptoms, and per-dialytic vital signs.
Receiving outpatient maintenance HD therapy.
Age ≥ 21 years.
Negative serum pregnancy test for women of child-bearing capacity. Childbearing capacity will be defined by report of menstruation within ≤ 6 months.
Currently incarcerated.
Insufficient capacity for informed consent.
Non-hemolyzed serum potassium concentration >6.0 mEq/L within ≤30 days.
Unscheduled HD for hyperkalemia within ≤30 days.