<p> 2390</p><p>PRO-ACTIVE INDIVIDUALISED DIETARY MODIFICATION REDUCES THE PREVALENCE OF HYPERKALAEMIA IN PATIENTS WITH ADVANCED CKD Helen L MacLaughlin, Deepa Kariyawasam, Sorcha Kenny, Nicola Marsh, Helen Clackson Department of Nutrition and Dietetics, King’s College Hospital</p><p>Introduction The prevalence of hyperkalaemia in structured multidisciplinary clinics for patients with advanced CKD is not well known. Whilst the UK Renal Association Clinical Practice Guidelines on the Detection, Monitoring and Care of Patients with CKD suggest that patients with hyperkalemia receive dietary education to modify potassium intake, information on the effect of pre-emptive individualised potassium dietary education after dietary assessment has not been widely reported. This study aims to determine if the prevalence of hyperkalemia is reduced with regular nutrition assessment and dietary education in a population of patients attending a pre-dialysis clinic.</p><p>Methods Nutrition assessment data was collected prospectively throughout 2014, including serum potassium, phosphate, weight, BMI, MDRD eGFR, SGA status and dietary education topics, for all patients seen by a dietitian in the clinic during initial assessments and at regular 6 monthly assessments. The rate of dietary interventions addressing the modification of potassium was determined for normo- and hyperkalemic patients.Hyperkalaemia was defined as serum potassium >5.5mmol/L,and the prevalence of hyperkalaemia in 2014 was compared to the population in the same clinic in 2011 (1) with chi-squared analysis.Between 2011 and 2014, an additional 0.5WTE specialist renal dietitian was added.</p><p>Results 356 patients attended an advanced CKD (non-dialysis) clinic in 2014, including 156 (44%) patients new to the clinic in 2014 and 200 (56%) attending for regular review. Mean age was 65.4 (± 16) years, 255 (71.6%) were male, and the eGFR range was 8-20ml/min/1.73m2). 352 (99%) patients underwent nutrition assessment by a specialist renal dietitian, all including Subjective Global Assessment (SGA) and individually tailored dietary education, in 475 individual consultations. 78% of patients were well nourished (SGA rating A) and 22% were malnourished (SGA rating B/C). Mean serum potassium was 4.9 (±0.5) mmol/L, and the prevalence of hyperkalaemia > 5.5 mol/L and >6.0 mmol/L was 10.5% (50/475) and 2.5% (12/475) in 2014, compared to 26.5% (63/238) and 8.4% (20/238) in 2011 (chi sq=30.22; p <0.01 and chi sq= 12.77; p<0.001, respectively). Dietary education on potassium was provided in 30% (135/475) of nutrition assessments, including in 78% of patients with hyperkalaemia and 22% of patients with normal serum potassium. </p><p>Conclusions Regular nutrition assessment and dietary education may reduce the prevalence of hyperkalaemia in patients with advanced CKD not on dialysis. Preventative individualised education delivered by specialist renal dietitians may be an effective strategy to reduce the costs and anxiety associated with managing hyperkalaemia in this population.</p><p>Reference Pantelis A. Sarafidis, Rochelle Blacklock, Eleri Wood, Adam Rumjon, Shanique Simmonds, Jessica Fletcher-Rogers,Rachel Ariyanayagam, Aziza Al-Yassin, Claire Sharpe, and Katie Vinen. Prevalence and Factors Associated with Hyperkalemia in Predialysis Patients Followed in a Low-Clearance Clinic. Clin J Am SocNephrol 2012, 7: 1234–1241. 2012</p>