Following a Lower-Potassium Diet to Manage Hyperkalemia

Chicken in curry sauce
Philippe Desnerck / Getty Images

If you have chronic kidney disease, your doctor will likely talk to you about how to manage your body’s potassium levels through medications and dietary changes. Hyperkalemia (when you have too much potassium in your blood) is common in those with chronic kidney disease and it's important to manage so that it doesn't become fatal.

What Is Potassium and What Does It Do?

Potassium is one of the major dietary minerals, along with calcium, magnesium, chloride, phosphorus, and sodium.

It's essential for normal muscle and nervous system function, and it helps regulate your body's pH balance and works with sodium to maintain normal blood pressure levels.

The average adult should have about 4,700 milligrams of potassium each day, but if you're on a potassium-restricted diet, you'll need to be mindful of foods that are high in potassium.

Eating a Healthy Diet While Limiting Potassium

Since potassium essentially counteracts sodium in the regulation of blood pressure, it's no surprise to learn that foods high in potassium are generally considered to be healthy foods, especially fruits and vegetables. In order to follow a low-potassium diet, you'll need to limit some healthy foods. But don't worry—there are plenty of healthy foods that you can still eat.

Along with reducing your potassium intake, it's also a good idea to avoid alcohol, high-fat foods, and fast foods that aren't very nutritious.

It may also help to drink more water (ask your doctor how much water you should be drinking every day).

Hyperkalemia is usually caused by illness or medication, but in rare cases, it can happen if a person takes large doses of potassium supplements. Although potassium is an essential nutrient, it's best not to use potassium supplements, unless directed by your doctor to do so.

Foods High in Potassium

Vegetables such as spinach, carrots, collard greens, beet greens, Swiss chard, taro, artichokes, sweet potatoes, yams, tomatoes, potatoes, avocado, beets, bok choy, okra, pumpkin, squash, parsnips, Brussels sprouts, and mushrooms, are all high in potassium. So are any snacks or side dishes made with those veggies.

Papaya, melons, mangos, dried fruits, dates, nectarines, pomegranate, bananas, kiwi, pears, apricots, prunes, and tomato products all need to be avoided while you're on a diet for managing hyperkalemia.

It's essential to avoid dairy products, except for cheese and sour cream, noted in the next section. Cut back on yogurt, regular and flavored milk, and buttermilk. You'll also need to be mindful of molasses, fruit, and vegetable juices and sports drinks.

Whole grains are another group of foods that are generally considered healthy, but they're high in potassium, so you'll need to be mindful of them as well. That includes bran, granola, oats and oatmeal, bread, baked goods, and cereals made with whole grains.

Dry beans like pinto, kidney, black, or navy beans are all high in potassium, and so are lentils, Lima beans, and soybeans. Nuts, peanuts, peanut butter and pumpkin seeds also need to be avoided.

Salmon, halibut, clams, and red meat can also be high in potassium. 

Salt substitutes deserve a note of their own. They may be sodium-free, but when potassium is used as a replacement, they become high in potassium. Do not use any type of salt substitute that has potassium. Instead, use herbal blends and seasonings.

Healthy, Lower-Potassium Foods That You Can Eat

That seems like a rather long list of foods that are high in potassium, but maybe it will help to look at some of the foods you can eat if you have hyperkalemia.

You can still eat some fruits and vegetables. For example, green beans and wax beans are low in potassium.

So are peppers, beets, eggplant, cabbage, water chestnuts, asparagus, broccoli, cucumbers, corn, alfalfa sprouts, radishes, snow peas, and iceberg lettuce.

As far as low-potassium fruit, you can enjoy apples, blackberries, blueberries, cherries, peaches, grapefruit, fresh plums, raspberries, grapes, cranberries, lemons, limes, and strawberries—all can be safely eaten on a low-potassium diet.

Hard cheese, cottage cheese, and eggs are all allowed on the diet. Rice milk makes a good substitute for cow's milk.

While it's a good idea to avoid whole grains, white refined flour is fine, so you can have cookies, corn chips, English muffins, pasta, baked goods, and cereals made with refined flour. You can also have crackers, doughnuts, rice, and popcorn. Not all of these are healthy choices, of course, so enjoy in moderation.

Fresh poultry, including chicken and turkey, are good for a low-potassium diet. Fresh pork is also acceptable. Just avoid sausage, bacon, or other meats that may have additives that contain potassium.

Examples of Healthy Low-Potassium Meals and Snacks

Breakfast Examples:

  • white toast with jam, a small glass of grape juice, and a hard boiled egg.
  • cornflakes with rice milk and fresh blueberries, toast with butter, cinnamon, and sugar.
  • scrambled eggs, cottage cheese, and fresh strawberries.

Lunch Examples:

  • a sandwich made with white bread, sliced cucumbers, cream cheese, and dill weed.
  • Chicken fajitas with white flour tortillas, peppers, onions, chili powder, and lime.
  • White pasta with sliced asparagus, peppers, and onions with olive oil and herbs.

Dinner Examples:

  • Turkey meatloaf made with egg, white bread crumbs, parsley and Worcestershire sauce, green beans, and white rice.
  • Chicken with curry sauce, broccoli and carrots, and a small salad made with iceberg lettuce.
  • Lean pork chops with coleslaw and red beets.

Snack Ideas:

  • White crackers with cheese slices.
  • Cottage cheese with blueberries.
  • Smoothie made with raspberries, rice milk, and crushed ice.

Low-Potassium Diet Tips

Read labels on all store-bought food items. New nutrition labels require potassium quantities to be displayed, but until then you can look at the ingredients list to make sure there are little to no potassium-rich foods.

Water is a good beverage, but you can also drink lemonade and fruit juice made from fruit in the low-potassium list. Tea is also acceptable and can be served hot or on ice with lemon and sugar or honey.

Always aim for healthy foods. If you need to lose or gain weight, talk to your doctor and dietitian, who can help you determine the right number of calories to consume every day.

Sources:

American Family Physician. Hyperkalemia.

Batra V, Villgran V. Hyperkalemia from Dietary Supplements.Cureus. 2016 Nov 2;8(11):e859.

Saha S, Rahman M. Nephrology Update: Chronic Kidney Disease. FP Essent. 2016 May;444:18-22.

University of Maryland Medical Center. Hyperkalemia.

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.

Continue Reading