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Potassium and the kidney diet

Potassium is a mineral that critically affects the proper functioning of your nerves and muscles. In particular, your heart is influenced by the amount of potassium in your bloodstream. When potassium levels become too high, your heartbeat may be become irregular, and you could even have a heart attack. In order to stay healthy, your potassium blood level should be in the range of 3.5 to 5.5 mEq/L.

When kidneys are healthy, they help balance your body’s potassium levels. However, if you have chronic kidney disease (CKD), you may need to be careful about eating foods that contain potassium, or your blood level of potassium could become too high.

How do I know if my potassium level is too high?

Your health care provider will run blood tests to monitor your potassium levels to be sure they are in the normal range. However, if you experience any of the following, you may be experiencing hyperkalemia (elevated levels of potassium in your blood stream) and you should contact your doctor right away:

  • nausea 
  • weakness
  • slow pulse 
  • irregular heartbeat 
  • numbness or tingling

Dialysis treatment removes extra potassium from your blood. However, hemodialysis treatment is usually only three times a week for three to four hours, so potassium can build up between dialysis treatments. You may be instructed by your renal dietitian to limit potassium in your diet.

For some people on peritoneal dialysis, they may be instructed to eat foods with potassium since peritoneal dialysis is done everyday. Your renal dietitian will review your lab results with you each month, including your potassium levels, and let you know how much potassium you can consume.

How can I control the potassium in my diet?

There are a number of steps you can take to help regulate your potassium level for better health:

  • Begin by consulting with your renal dietitian to learn which foods are high in potassium. Get help developing an eating plan that meets your unique needs.
  • Your goal is to eat a variety of healthy foods. Be aware of portion control and make moderate eating a way of life. Recognize that most foods contain some potassium, so eating more than a normal portion may mean putting yourself at risk for increased potassium levels.
  • Limit foods that are high in potassium, including certain vegetables, fruits, milk and milk products. Your dietitian can tell you exactly which ones you need to avoid or limit.
  • Do not consume liquids from canned fruits and vegetables.
  • Become a label reader. Check “low salt” and “low sodium” packaged foods to be sure that they do not contain potassium ingredients such as potassium chloride.
  • Avoid salt substitutes with potassium. Instead, flavor your meals with healthier alternatives, such as lemon, herbs and spices.
  • Be sure to stick with your regularly scheduled dialysis treatments and stay on dialysis for the entire treatment period so that your blood can be sufficiently cleaned.

What is leaching?

If you would like to include high-potassium vegetables, such as potatoes, sweet potatoes or carrots, in your meal plan, you can use the process of leaching to lower the amount of potassium in the food. It’s a simple process that can help make your food healthier for people with kidney disease and still allow you to enjoy some of your favorite veggies. Ask your dietitian for help in learning which vegetables can be safely leached and eaten as part of your kidney-friendly diet.

Here’s an easy way to leach potassium from root vegetables such as potatoes and carrots:

  1. Start by peeling the vegetable and cutting it into small pieces.
  2. Rinse the veggies and place in a large pot. Fill the pot with water so that the veggies are covered completely.
  3. Allow the vegetables to soak overnight or for at least 4 hours.
  4. Once they have finished soaking, rinse them once again and cook as desired.

You can also leach potassium from mushrooms, cauliflower, squash and frozen greens.

  1. If the vegetable is frozen, allow to thaw to room temperature. Drain.
  2. Rinse vegetable briefly in warm water.
  3. Soak in warm water for at least 2 hours and rinse once again.
  4. You can now cook the vegetable as you normally would, using 5 parts water to every one part of veggie.

Even after leaching, remember to continue to limit your portion size to one serving, which is usually about 1/2 cup.

Eat this, not that

With some pre-planning, you can select low-potassium foods that are healthier for your body, yet still enjoy many of the food categories you’ve always loved. Take a look at the chart below for some hints on making smart choices.

Enjoy Instead of
A small piece of watermelon     Cantaloupe, honeydew
Berries, grapes, apples Bananas, oranges, kiwi
Apple, grape or cranberry juice Orange juice or prune juice
Dried cranberries Raisins, other dried fruit
Plum, peach, pineapple Mangoes, nectarines, papaya
Lower potassium canned peaches, peaches, fruit cocktail Fresh fruit
peas, green beans, wax beans Dried peas or beans
Mashed potatoes or hash browns made   from leached potatoes Baked potatoes or French fries
Summer squashes Winter squashes
Pudding prepared with nondairy creamer Yogurt or pudding made with milk
Sorbet, sherbet Ice cream or frozen yogurt
Plain donuts or desserts that are lemon  or vanilla flavored Chocolate desserts
Rice cakes, unsalted popcorn or pretzels, jelly beans, hard candies  Nuts or seeds
Lemon, pepper, low sodium herb and   spice blends Salt substitutes
Cook with garlic, onion, bell peppers  or mushrooms Tomatoes, tomato sauce, chili sauce
Ice water with sliced lemons or sliced cucumber Vegetable juices
Unenriched rice milk or nondairy creamer Cow’s milk

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