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Potassium and Your Diet

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)
Low Medium High

(Potassium contents from USDA SR 17)



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