Controlling High Potassium in Chronic Kidney Disease

Many chronic kidney disease patients I’ve worked with have questions about what’s important with potassium control. Not all people with CKD need to restrict potassium. In early stages of CKD, potassium usually is not a problem because the kidneys still remove enough to keep blood levels normal. In some cases, elevated potassium may return to normal with adjustments in medication, especially if a person is on potassium sparing diuretics. If medications are adjusted and levels continue above normal, a lower potassium diet is needed.

Kalium-Latin for Potassium

What’s the link between potassium and kidneys? 90% of the excess potassium consumed through diet is removed by your kidneys. As you lose kidney function, less potassium is removed and blood levels go higher. Controlling potassium often becomes an issue as a person approaches stage 5 CKD. That’s when levels start to rise above normal, which is 3.5-5.0 mEq/L.

Most dietary potassium comes from milk, animal protein, fruits and vegetables. Legumes, nuts and potassium based salt substitutes contain lots of potassium too. Here are some things to do if your potassium is too high:

Stop using potassium based salt substitutes.
Check labels on low sodium products to be sure potassium chloride is not on the ingredient list.
Check the Nutrition Facts label to see if potassium content is listed. Compare and choose the lowest potassium products.
Learn which fruits and vegetables are highest in potassium. Eat these foods less frequently and in smaller portions or replace with lower potassium choices. Some high potassium foods include avocado, banana, cantaloupe, kiwi, oranges, papaya, beans, potatoes, tomatoes, spinach, sweet potato, winter squash and vegetable juice.
Limit milk and yogurt—both are very high in potassium.
Check labels on soy products. Some soy milks contain over 300 mg potassium for an 8 ounce serving.
Read DaVita.com articles for more information: Potassium and Chronic Kidney Disease and Lowering Potassium in Potatoes
Use DaVita Diet Helper to download 2 weeks of meals that are below 2000 mg potassium a day.
Ask your dietitian how much meat (including fish and poultry) is right for you to eat each day.
Ask your dietitian for additional information on high and low potassium foods.