John Rippon says the public and policymakers should be aware of the potential harm caused by potassium chloride and Mike Pender says there is no need to add more salt, or substitutes, to food

Re your report in the print edition (Salt substitute cuts risk of heart attack – study, 31 August), it was with great alarm that I read the statement attributed to Prof Bruce Neal that “if you were to replace all of the salt on supermarket shelves with salt substitutes, you would prevent thousands of strokes and heart attacks every year”. According to a report by NHS Kidney Care, “more than 1.8 million people in England have diagnosed chronic kidney disease (CKD). In addition, there are thought to be around a million people who have the condition but are undiagnosed. CKD can substantially reduce quality of life, and leads to premature death for thousands of people each year.”

Most diagnosed kidney patients must strictly limit their intake of potassium as an excess of this element in the body can lead to stroke and sudden heart failure. As the report states, the most ubiquitous substitute for sodium chloride (common salt) is potassium chloride. Therefore, far from preventing strokes and heart attacks, such a widespread substitution could cause many thousands of extra such occurrences among patients with significantly reduced kidney function. As a kidney dialysis patient, I believe that this fact should be made widely known among the public, but particularly among potential policymakers.
John Rippon
Witton Gilbert, County Durham

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