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Kidney Disease and Potassium

Anna Sramek, RD
May 13, 2022
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Potassium is a mineral we need for our health. It helps control our nerves and muscles, which is important for our heart and helps manage our blood pressure. While we need potassium to live, people with chronic kidney disease (CKD) need to pay attention to their potassium intake. In this article, we will review why monitoring potassium is important, and what foods should be limited to avoid high potassium levels.

Why is Monitoring Potassium Important in CKD?

People with CKD have reduced function in their kidneys, which decreases their ability to filter fluids and electrolytes (like potassium) from the body. Too much potassium, or hyperkalemia, can cause serious side effects like chest palpitations, abnormal heart rhythms, and muscle weakness.

While we want to prevent hyperkalemia, we also want to prevent low potassium levels, or hypokalemia. Hypokalemia symptoms include metabolic acidosis, respiratory failure, or abnormal heart rhythms.

In other words, we want our potassium levels in the blood to be just right. You can manage this with what you eat.

Which Foods Have Potassium, and which Do Not?

If you’ve been told that you have low levels of potassium, you may want to eat foods that contain medium to high potassium content more often. On the contrary, you may want to eat foods that contain low potassium if you have high levels of potassium in your blood. Check the list below to see what you need.

High, Medium, and Low Food Sources of Potassium
(Adapted from the USDA Food Data Central Repository)

Foods Highest in Potassium
~approx. 10% or more DV per serving
Moderate Potassium
~approx. 5-9% DV per serving
(Adapted from the USDA Food Data Central Repository)
Low Potassium*
~4% or less DV per serving
Vegetables: Beet greens (and most other leafy greens), pumpkin, acorn, and winter squash, tomato products (juices, sauces, paste) Artichokes, kale, corn, fennel, mushrooms, rutabaga, asparagus, and summer squash, fresh tomatoes, broccoli, cauliflower Napa cabbage, iceberg lettuce, romaine lettuce, carrots, celery, leeks, radishes, cucumbers, green peas, parsley, cilantro, eggplant, coleslaw, capers,
*Moderate-potassium vegetables that are boiled and water discarded
Fruits: Bananas, guava, kiwi, passion fruit, jackfruit, soursop, mamey, cantaloupe and honeydew, dried fruit, oranges and orange juice, avocado, cherimoya Pomegranate, apricots, honeydew melon, cherries, lychees, grapefruit, lemon, and other citrus, mangoes, mulberries, persimmon, papaya, plum, strawberries and blackberries Blueberries, longan berries, apples, grapes, cranberries, pears, watermelon
Carbohydrates: Legumes (beans and lentils), potatoes, yams, taro, most foods with wheat or whole wheat flour 'Silk' brand soy milk, Tofu, fava beans (broad beans), lupin beans, peanut butter, falafel, hummus, foods with white flour

White rice, wheat melba toast crackers, rice noodles, fermented tofu (fuyu), boiled potatoes, taro, yams (with water discarded)

Dairy: Milk and yogurt Goat milk, unsweetened rice milk, oat milk Unsweetened almond milk, soft goat cheese, queso cotija
Protein: Fish: Salmon, snapper, mahi-mahi, tilapia, chicken dark meat Chicken white meat, peanuts, almonds, pistachios, cashews, walnuts, chestnuts, squash/pumpkin seeds, flax seeds Eggs, chia seeds
Fats: None are high potassium None are moderate potassium All fats: olive, canola, peanut, corn, flaxseed, and other oils, butter and ghee, mayonnaise, olives
Flavorings: Salt substitutes and low-sodium foods that contain potassium additives None are moderate potassium Vinegar, imitation vanilla extract, ginger, fresh herbs, nutmeg, hot sauce, yellow mustard

*Quick tip: If you occasionally decide to have some medium or high potassium foods, and you have been told to avoid these, steam or boil them to help reduce potassium content, and toss out the water. By cooking them in water, much of the potassium gets leached out into the water.

Takeaways

Potassium is an essential nutrient that helps our muscles move and can even help lower blood pressure. However, balanced potassium levels are important, especially in CKD. By getting regular labs done and working with your doctor or Registered Dietitian, you can find a balance of potassium intake to help reach your optimal health!

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