Greetings,
I do not recommend the use of potassium chloride as a salt substitute. Besides it having a bitter taste, we get plenty of potassium from the food we eat and when we take in more in the form of a concentrated "supplement," especially one we can freely use, we can run the risk of getting in too much potassium. Too much potassium can cause hyperkalemia, heart arrhythmia's and if enough is ingested, even cardiac arrest. Hyperkalemia can lead to paresthesia, cardiac conduction blocks, fibrillation, arrhythmia's, and sclerosis.
The risks of this increases in someone with impaired renal function, diabetes, and/or heart disease. Considering the health status of most Americans, I do not think having such a product freely available is a good idea.
For the record, this is the same chemical that comes with a skull and crossbones on it when sold to melt ice and is the same chemical that is used in lethal injections.
I would rather see someone use salt within the limits recommended or switch to salt free (and potassium chloride free) spices and seasonings.
In Health
Jeff
Perit Dial Int. 2012 Mar-Apr;32(2):206-8. doi: 10.3747/pdi.2011.00198. Severe hyperkalemia in a peritoneal dialysis patient after consumption of salt substitute. Yip T1, PMID: 22383720
Am J Emerg Med. 2011 Nov;29(9):1237.e1-2. doi: 10.1016/j.ajem.2010.08.029. Epub 2010 Nov 13. Life-threatening hyperkalemia from nutritional supplements: uncommon or undiagnosed? John SK1, Rangan Y, Block CA, Koff MD.
Abstract
Potassium chloride and other potassium compounds are used by the general public as salt substitutes, muscle-building supplements, and panacea. Severe hyperkalemia from oral potassium is extremely rare if kidney function is normal because of potassium adaptation. The oral potassium dose has to be large enough to overcome the normal renal excretory mechanisms to cause severe hyperkalemia. This occurs most commonly in patients with renal impairment or those who take potassium-sparing diuretics, angiotensin receptor blockers, or angiotensin-converting enzyme inhibitors. We present two unique cases of near-fatal hyperkalemia from nutritional supplements containing potassium. The first case was due to salt-substitute intake, whereas the second case was from a muscle-building supplement. Both patients suffered cardiac arrest, but were successfully resuscitated and survived. The acuity of intake and excessive quantity overwhelmed the kidneys' ability for adaptation. Potassium toxicity affects multiple organ systems and manifests in characteristic, acute cardiovascular changes with electrocardiographic abnormalities. Neuromuscular manifestations include general muscular weakness and ascending paralysis may occur, whereas gastrointestinal symptoms manifest as nausea, vomiting, paralytic ileus, and local mucosal necrosis that may lead to perforation. Once an urgent situation has been handled with intravenous push of a 10% calcium salt, short-term measures should be started with agents that cause a transcellular shift of potassium, namely, insulin with glucose, β2-agonist, and NaHCO(3). Patients are unaware of these potentially serious adverse effects, and there are inadequate consumer warnings. Clinicians should be vigilant in monitoring potassium intake from over-the-counter supplements.
J Am Med Dir Assoc. 2005 Nov-Dec;6(6):400-5. Epub 2005 Sep 26. Life-threatening, preventable hyperkalemia in a nursing home resident: case report and literature review. Dharmarajan TS, Nguyen T, Russell RO. New York Medical College, Valhalla, NY, USA.
[email protected] <
[email protected]>
Abstract
A 70-year-old male nursing home resident, hospitalized for weakness and lethargy, was found to have life-threatening hyperkalemia. Concomitant use of potassium chloride, spironolactone, and propranolol appeared the likely offending agents. Hyperkalemia is common in the elderly, resulting from a combination of potassium homeostasis disorders, disease processes and certain medications. In particular, older adults in the nursing home on spironolactone and potassium replacement preparations should have serum potassium monitored frequently, particularly in the presence of renal insufficiency and diabetes. Also included is a review of literature illustrating alterations in potassium regulation in older adults and a suggested approach to potassium-related disorders in the nursing home setting. PMID: 16286062
Restuccio A. Fatal hyperkalemia from a salt substitute [letter] Am J Emerg Med 1992 Mar;10(2):171-3.
Riccardella D, Dwyer J. Salt substitutes and medicinal potassium sources: risks and benefits. J Am Diet Assoc 1985 Apr;85(4):471-4.
The purpose of this investigation was to gather and summarize currently available product information on salt substitutes, low-sodium products, and medicinal potassium supplements. A review of the literature identified both risks (e.g., hyperkalemia) and benefits (e.g., changing sodium:potassium ratios, and low-cost substitutes for medicinal potassium replacement) resulting from the use of salt substitutes. Risks and benefits are related to individual patient conditions and treatment plans. Nutritionists and
physicians must be aware of the medicinal and dietary potassium sources and be able to educate patients in the proper use of the products. Lists of medicinal and dietary sources of potassium are provided to aid health professionals in determining appropriate potassium equivalents. Case reports from the literature of patients developing hyperkalemia secondary to the use of salt substitutes are summarized. Regular monitoring of serum potassium levels is necessary to achieve and maintain normal values.
Ponce SP, Jennings AE, Madias NE, Harrington JT. Drug-induced hyperkalemia. Medicine (Baltimore) 1985 Nov;64(6):357-70.
After reviewing the available data on drug-induced hyperkalemia, we conclude that the situation has not improved since Lawson quantitatively documented the substantial risks of potassium chloride over a decade ago (90). As discussed, the risk of developing hyperkalemia in hospital remains at least at the range of 1 to 2% and can reach 10%, depending on the definition used (Table 2). Potassium chloride supplements and potassium-sparing diuretics remain the major culprits but they have been joined by a host of new actors, e.g., salt substitutes, beta-blockers, converting enzyme inhibitors, nonsteroidal antiinflammatory agents, and heparin, among others. Readily identifiable risk factors (other than drugs) or developing hyperkalemia are well-known but seem to be consistently ignored, even in teaching hospitals. The presence of diabetes mellitus, renal insufficiency, hypoaldosteronism, and age greater than 60 years results in a substantial increase in the risk of hyperkalemia from the use of any of the drugs we have reviewed. If prevention of hyperkalemia is the goal, as it should be, the current widespread and indiscriminate use of
potassium supplements and potassium-sparing diuretics will need to end. We remain intrigued by Burchell's prescient pronouncement of over a decade ago that "more lives have been lost than saved by potassium therapy" (28)
McCaughan D. Hazards of non-prescription potassium supplements [letter] Lancet 1984 Mar 3;1(8375):513-4.
Yap V, Patel A, Thomsen J. Hyperkalemia with cardiac arrhythmia. Induction by salt substitutes, spironolactone, and azotemia. JAMA 1976 Dec 13;236(24):2775-6.
In two patients, severe hyperkalemia and serious cardiac arrhythmia developed after excessive use of potassium-containing salt substitutes. Both had impaired ability to handle and excrete additional potassium load due to chronic congestive heart failure, azotemia, and administration of spironolactone. Prompt recognition of the arrhythmia and immediate restoration of the cardiac rate and rhythm by pacemaker support followed by intensive regimen to lower the serum potassium prevented a potentially
fatal outcome. These cases emphasize the potential danger of salt substitutes when used by patients who are predisposed to retain potassium.
Wetli CV, Davis JH. Fatal hyperkalemia from accidental overdose of potassium chloride [letter] JAMA 1978 Sep 22;240(13):1339.
Kallen RJ, Rieger CH, Cohen HS, Sutter MA, et al. Near-fatal hyperkalemia due to ingestion of salt substitute by an infant. JAMA 1976 May 10;235(19):2125-6.
by HealthFreak » Wed May 20, 2009 1:16 pm 
