Potassium and Peritoneal Dialysis: Avocado and Tomato Please

Imagine this scenario. You are a fairly new dialysis patient who recently finished training for peritoneal dialysis (PD).You have started doing treatments in the comfort of your home. You’re checking your steps carefully, following every step that your nurse trained you on for two weeks. Your second set of lab results are reviewed—and your potassium level is LOW! This is a change from previous high levels.

By now you may hardly remember the early encounter with your dietitian. They may have told you that when you start doing your PD exchanges daily, you will lose potassium daily. You may have forgotten about increasing your daily intake of potassium-rich foods for many reasons. Perhaps in the hospital or the doctor’s office you were told to avoid potassium-rich foods. You may have had high potassium levels before starting dialysis. High potassium in the blood is dangerous.

Fast forward to now. You learned to do the proper PD exchanges. You are making sure you follow every step. Most of what the renal dietitian told you some weeks ago may be forgotten. The meal plan booklet given to you during earlier days of training is there to guide you now. Since you are in the comfort of your home, go and review the list of all those yummy fruits and vegetables you can NOW enjoy on a daily basis.

Yes!  When you are on a liberal potassium plan you can have a piece of melon for breakfast, a baked potato with roasted chicken, a green salad with avocado slices, or a delicious plate of spaghetti with tomato sauce and a baby spinach salad. Those are some of the delicious higher potassium food options.

The reason many PD patients can often eat higher potassium foods is because PD exchanges clean your blood well, and remove potassium on a daily basis. If you are still making urine, you are losing even more potassium. This may cause low blood potassium levels.

A normal potassium level is 3.5-5.5 mg/dl. Potassium’s most important job is muscle control in the body, and your heart is your most important muscle. Keeping potassium between 3.5 mg/dl to 5.5 mg/dl is important, especially for your heart.  Levels that are too low are as serious as levels that are too high. And with PD therapy most patients do not need to follow a low-potassium eating plan.

So go ahead, ask for more avocado and tomatoes please. Your PD nurse and dietitian will keep you informed about your potassium and recommend changes in your meal plan when needed.

For a list of low and high potassium foods read “Potassium and Peritoneal Dialysis” by the DaVita dietitian team.