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 become irregular, and you could even have a heart attack. 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 could become dangerously high.
Signs of High Potassium (Hyperkalemia)
Your health care provider will run regular blood tests to monitor your potassium levels. However, if you experience any of the following, you may be experiencing hyperkalemia and should contact your doctor right away:
- Nausea
- Weakness
- Slow pulse
- Irregular heartbeat
- Numbness or tingling
Since hemodialysis treatment is usually only three times a week, potassium can build up between treatments. Patients on peritoneal dialysis sometimes have low potassium and can liberalize potassium in their diet, if recommended by their nephrologist.
How to Control Potassium in Your Diet
- Consult with your renal dietitian to learn which foods are high in potassium and develop a personalized eating plan
- Practice portion control — most foods contain some potassium, so eating more than a normal portion increases your risk
- Limit high-potassium foods, including certain vegetables, fruits, milk, and milk products
- Do not drink liquids from canned fruits and vegetables
- Check "low salt" and "low sodium" packaged foods for potassium ingredients such as potassium chloride
- Avoid salt substitutes with potassium — use lemon, herbs, and spices instead
- Stay on dialysis for the full treatment period so 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, you can use the process of leaching to lower the potassium content.
Leaching root vegetables (potatoes, carrots):
- Peel the vegetable and cut it into small pieces
- Rinse the vegetables and place in a large pot, covered completely with water
- Soak overnight or for at least four hours
- Rinse again and cook as desired
Leaching other vegetables (mushrooms, cauliflower, squash, frozen greens):
- If frozen, allow to thaw to room temperature and drain
- Rinse briefly in warm water and soak in warm water for at least two hours
- Rinse once more, then cook using five parts water to every one part vegetable
Even after leaching, continue to limit your portion size to one serving (usually about half a cup).
Smart Food Swaps
| Choose These | Instead Of These |
|---|---|
| A small piece of watermelon | Cantaloupe, honeydew |
| Berries, grapes, apples | Bananas, oranges, kiwi |
| Apple, grape, or cranberry juice | Orange or prune juice |
| Dried cranberries | Raisins or other dried fruits |
| Plum, peach, pineapple | Mangoes, nectarines, papaya |
| Canned peaches or fruit cocktail (drained) | Fresh high-potassium fruit |
| Peas, green beans, wax beans | Dried peas or beans |
| Mashed or hash browns from leached potatoes | Baked potatoes or French fries |
| Summer squashes | Winter squashes |
| Pudding prepared with non-dairy creamer | Yogurt or pudding made with milk |
| Sorbet or sherbet | Ice cream or frozen yogurt |
| Lemon, pepper, low-sodium herb blends | Salt substitutes |
| Garlic, onion, bell peppers, mushrooms | Tomatoes, tomato sauce, chili sauce |
| Ice water with lemon or cucumber | Vegetable juices |
| Unenriched rice milk or non-dairy creamer | Cow's milk |