Potassium and Kidney Disease: The Diet Rule You May Need to Follow
Has your doctor talked with you about potassium? Maybe to eat more bananas? Or to cut out potatoes and tomatoes? Did they give you a kidney disease diet brochure and speak to cutting back dark greens or no more orange juice?
Potassium is a highly individualized nutrient in kidney disease where the body’s needs can change greatly depending on the function of kidneys, current medications, and other health conditions or family history of health complications.
Before I dive more into this topic, I want - no, need - to stress the importance of working with your own medical team on the potassium requirements for your health. Please speak with your doctor and dietitian about your potassium recommendations and what to do about your diet to serve your health best.
Let’s dive in.
Potassium is a very important mineral in the body that takes on a lot of important roles.
Potassium helps regulate your fluid balance, including blood pressure, helps with your muscle contractions and heartbeat, and is a big part of nerve signals throughout the body.
It's actually the third most abundant mineral in our body, behind calcium and phosphorus. It’s the most abundant anion inside our cells (this helps balance fluids).
Potassium for Prevention
Did you know that 98% of Americans do not include enough potassium in their diet? NINETY EIGHT PERCENT. This is one of the arguments to include potassium on food labels - so people can identify foods that are higher in potassium.
As mentioned, a high potassium diet has been shown to help lower blood pressure and help in prevention of hypertension. Hypertension, or high blood pressure, is one of the leading causes of kidney failure.
Increasing potassium-rich foods in your diet can be an excellent way to prevent high blood pressure and chronic kidney disease.
Potassium Lab Values: Know what’s good and what’s dangerous
The range of potassium in our blood should be between 3.5 - 5.0 mg/dL.
If there is a higher level of potassium in the blood, also known as hyperkalemia, puts you at risk for irregular heart beats, heart attack, and sudden death.
A potassium level between 5.0 - 6.0 puts you at higher risk of a cardiac complications.
If your potassium is over 6.0, you are at a dangerous level for your heart.
Recommended Daily Potassium Intake
Those without a potassium restriction can and should aim for 3,500 - 4,700 milligrams per day. If you do not have kidney disease, you will not be at risk for hyperkalemia as your kidneys will filter any excess potassium via urine excretion.
If your doctor and dietitian have spoke with you about limiting potassium, your restriction could be anywhere from 2,000 to 3,000 milligrams per day.
This will vary person-to-person, so it is very important you work closely with your dietitian in reviewing diet recalls to see what daily allowance is best for your health.
Reading the Label
Unfortunately, potassium is not yet a required nutrient to be included on the nutrition labels of packaged foods. (But will start to be added to the new nutrition labels!)
In the nutrition label example here, potassium will be listed at the bottom. You may otherwise find potassium listed higher in the label between sodium and carbohydrate.
If you only see potassium listed as a percentage, it will be based off of 3,500 milligrams.
Until the new guidelines are set in place, the unknown levels of potassium can present a challenge to those in need of restricting potassium. This is where some dietary guidance can help you determine if your potassium intake is appropriate for your kidney disease state.
Other considerations for controlling potassium
Besides diet, there can be other factors that may alter your potassium balance. Before making any changes, discuss these topics with your nephrologist or prescribing physician.
Some medications will prevent potassium from being released from the body, also known as "potassium-sparing." Most commonly are diuretics, which can either excrete more potassium or prevent potassium from being excreted.
Your doctor will take your health conditions and potassium levels into consideration when prescribing you a diuretic. Ask your doctor and dietitian how much potassium you should be eating based on the medications you are prescribed.
Blood Sugar Control
If you have diabetes it will always be important to regulate your sugars. If you have high glucose levels in the blood, it may cause more potassium to be pulled out of the cells, which will then increase your potassium level.
Address uncontrolled blood sugars with both your endocrinologist (diabetes doctor) or primary care doctor, as well as a registered dietitian. Diabetes may require best control from both diet and medication orders.
If you are experiencing frequent constipation you may find that your potassium levels are trending higher. On the other hand, if you have frequent diarrhea you could be losing more potassium. Speak with your doctor and dietitian to find relief in these problems as they should not be ongoing. Determining the underlying cause of the GI upset will be the most helpful.
Since potassium recommendations are based on lab results, kidney function, and dietary preferences, it is crucial that you work with a dietitian to determine the best amount you could and should be eating.
By determining a potassium-safe diet and using your food preferences, you can learn how to enjoy the best foods to still get the nutrients your body needs without risking the accumulation of potassium.
Stay tuned for my next post that talks more about where you can add (or take away) potassium in your diet!
Interested in working with me to determine your potassium recommendations? Request a free discovery session today.