How to Balance Potassium for the Kidney-Friendly Diet
As you may have read from my last post, potassium can be a very serious nutrient to be limited in kidney disease.
When your kidneys are not functioning enough, it can start to impact your potassium regulation. This is generally seen in the late and end stage kidney diseases - stages 4 and 5.
You should only restrict your potassium if your doctor has told you to do so. Otherwise, it can create hypokalemia. Just like high levels of potassium, low potassium in the body can create problems for our health as well.
Tracking your potassium levels, along with your glomerular filtration rate (or GFR), can help your team decide on the best diet, medication, and treatment plans for your kidney health.
Depending on your treatment plan and the levels of your potassium, your doctor may want a potassium re-check as soon as the next day. Or they could wait several months before the next lab draw. Your job is to stay in communication with your doctor by coming to all planned follow-up sessions.
The quickest way to change potassium in our system is to change the way we eat. Potassium is often found in fruits, vegetables, dairy, nuts and legumes. This may sound contradictory to what you've been told before about following a kidney-friendly diet.
Don't worry! You do not need to eliminate all plants in your diet. There will likely be changes to the types of fruits and vegetables you choose to prevent hyperkalemia.
Fruits are a great way to get in important nutrients for the body including fiber, antioxidants, vitamins and minerals. Even with a potassium restriction, you can fit fruits into your day.
The general range of servings per day for fruits is 1-2 servings. One serving equals a small piece of fruit (think the size of your fist or a tennis ball), a 1/2 cup of cooked or a 1/4 cup of dried fruit.
Some of the most common high-potassium fruits include;
oranges / orange juice
pomegranate / pomegranate juice
prunes / prune juice
apple juice (occasionally low, but you need to check the label!)
As these are higher in potassium (over 200 milligrams per serving), it's best to limit these to occasional treats if you have been told to limit potassium.
You may be able to increase the number of servings if you focus on the lowest-potassium fruits. Working with a dietitian will give you a more specific guideline on the number of servings to aim for per day.
Here are some lower-potassium options you can include on a more regular basis:
Again, working with a dietitian will give you the best insight into the best sources of potassium you should include for your stage of kidney disease.
Vegetables are another great source of important nutrients that your body relies on to feel and do its best. Servings sizes are similar to fruits- a serving can look like 1 cup of raw (2 cups for leafy greens) or a 1/2 cup cooked vegetables.
Just like fruits, there are plenty of vegetables that are high or low in potassium. The trick is to identify the highest ones and limit them, while still enjoying from time-to-time.
Here are some of the highest-potassium vegetables;
beans (baked, refried, black, etc.)
tomato and tomato products (like tomato sauce)
Again, these are the vegetables you may need to limit when following a low-potassium diet. Including on occasion can be acceptable, but work with your dietitian to ensure it's the right portion.
Some lower-potassium vegetables to include;
lettuce (iceberg or romaine)
Aim for 2-3 servings of vegetables per day, unless otherwise determined by your dietitian.
Other foods high in potassium
A big no-no can be salt substitutes. These are often found to be primarily made from potassium chloride, which is why they are low in salt.
Better alternatives are spice blends like Mrs. Dash and Chef Prudhommes' blends, which include no salt nor potassium.
Here are other foods higher in potassium that may need to be limited;
bran (cereals, muffins, etc.)
milk (cow's, soy, some fortified plant-based)
nuts and nut butters
cheese and yogurt
You can read more about the best dairy, and use my comparison chart, in my previous blog post “What’s the Best Milk if I Have Kidney Disease?”
So how do you know what foods to eat more of and what to limit?
It is always best to work with a registered dietitian, trained in the renal diet and has professional work experience with kidney disease, to determine the safest and healthiest amount of potassium you should have.
If you want to work together or even want help finding another professional, book a free call so I can help you get squared away.