The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)

This episode is a refreshed re-release of our very first For Kidneys Sake podcast, updated to reflect current practice while reinforcing the core messages that remain just as relevant today.

Despite increased awareness, we are still seeing patients with chronic kidney disease (CKD) being referred urgently for potassium levels that are only mildly elevated. This episode revisits how to interpret potassium results correctly, including recognising spurious hyperkalaemia, understanding when repeat testing is appropriate, and being clear that levels in the 5.5–6.0 mmol/L range are usually not an emergency. Urgent action is typically reserved for levels above 6.5 mmol/L or when there are clinical concerns.

The refresh also highlights what has strengthened since the original release: even greater evidence supporting the continuation of RAAS inhibitors (ACE inhibitors, ARBs, and MRAs) in CKD and heart failure, alongside the growing role of newer potassium binders such as Lokelma and Veltassa to help patients stay on these vital therapies. We also revisit the persistent myth around dietary potassium—bananas are not the problem—and emphasise that restrictive diets are rarely the solution.

This updated episode offers reassurance, clarity, and practical guidance, while staying true to the original aim: reducing unnecessary panic and supporting confident, evidence-based management of hyperkalaemia in primary care.

This is a refreshed classic: A re-release of Episode 1, reinforcing key messages with updated evidence and current practice.

Don’t panic with mild elevations: Potassium levels of 5.5–6.0 mmol/L are usually not an emergency, repeat and review before acting.

Check for spurious results: Delayed sample processing is a common cause of falsely high potassium in primary care.

Keep life-saving medications going: ACE inhibitors, ARBs and MRAs should not be stopped unnecessarily, use potassium binders if needed.

Bananas aren’t the problem: Dietary restriction alone is rarely effective, focus on overall management rather than blaming specific foods.

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care Chronic kidney disease (nwlondonicb.nhs.uk)

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.

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