Potassium is a mineral found in all the foods we eat: some have more, some less. When your
kidneys were healthy, they removed any extra potassium in your body. There is a danger of high
potassium levels in your blood (hyperkalemia) when there is limited or no kidney function.
Potassium regulates your heartbeat and helps your other muscles function properly. If you have too much potassium in your blood you may develop a rapid heartbeat or general muscle weakness, cramps, or stiffness. These symptoms should be considered serious and receive immediate attention.
High potassium levels can be caused by reasons other than diet. Hyperkalemia can occur as the
result of an infection, or even a bad blood sample. The most common cause is missed dialysis
treatments. One missed treatment means that you would have 4 to 5 days worth of potassium in
your blood, which can lead to a heart attack! Don't skip or shorten your treatments!
For those of you receiving dialysis, the good news is that the treatments are effective in
removing potassium. Patients receiving peritoneal dialysis may even need potassium
supplements. Patients receiving hemodialysis need to maintain steady potassium intake, usually
around 2000 to 2500 milligrams a day; there are individual differences and your dietitian will be
able to tell you a safe level for your individual diet.
Major sources of potassium in the diet are fruits and vegetables. However, with good choices it
is not difficult to maintain a healthy potassium level. For example, here are some fruits that are
popular for breakfast with their potassium contents (1 cup servings):
blueberries (frozen) 138 mg
strawberries 276 mg
One medium banana 467 mg
As you can see, blueberries have 1/3 and strawberries have 2/3 the amount of potassium in the
banana.
How products are processed also makes a difference. Tomatoes are considered a high potassium
fruit, but their form can make a huge difference (1 cup servings):
tomato paste 2455 mg
tomato puree 1065 mg
tomatoes, fresh 400 mg
It is clear here that a tomato sauce made from fresh tomatoes, without tomato paste, would be
best.
Potatoes are also a popular high potassium vegetable. There are techniques to help reduce their
potassium content , but boiling alone helps:
baked Potato 844 mg
boiled Potato 515 mg
Rice and pasta are good substitutes for potatoes, and should a least be rotated with potatoes
throughout the week: white rice (1 cup) 222 mg; spaghetti (1 cup) 43 mg.
Potato chips count too. An ounce of potato chips has 494 mg of potassium, while corn chips have
about 40 mg—a tenth the amount!
Other substitutions can be more similar, as in the case of greens (1 cup servings):
beet greens 1309 mg
spinach 839 mg
kale 296 mg
turnip greens 292 mg
Obviously, turnips are a better choice than beet greens.
Protein foods such as meat, poultry, and fish also have potassium, but because of the body’s need
for protein we don’t restrict their intake. Generally, for counting purposes, you can figure 100
milligrams of potassium for each ounce of protein. For the average diet, that would be about
400-500 milligrams a day.
REMEMBER! One final item that is very important is to not use salt substitutes. These are often made by substituting sodium with potassium! These are very dangerous for dialysis patients and should not be used under any circumstances.
The key to controlling your potassium is to identify your favorite foods and their potassium
content. If they are high, try to think of substitutes. If they are foods you eat frequently, it may
be necessary to cut portions and frequency of these foods. Your dietitian can guide you in making good food choices and help you fit your favorite foods into your diet.
Examples of different potassium content in foods
(mg, 1/2 cup servings, Source: USDA)
REMEMBER! One final item that is very important is to not use salt substitutes. These are often made by substituting sodium with potassium! These are very dangerous for dialysis patients and should not be used under any circumstances.