Managing Potassium in a CKD Diet


Introduction

Potassium is a mineral that is present in all fruits, vegetables, meat and fish. It is the kidneys responsibility to maintain the proper amount of potassium in your body. Potassium plays a role in maintaining a regular heartbeat and keeping your muscles working right. Too much potassium can cause an irregular heartbeat or a heart attack. Since people with CKD have damaged or compromised kidneys, they may have trouble maintaining the proper amount of potassium. A normal potassium intake is around 3500 to 4500 mg per day. Anyone with a restricted potassium diet such as someone with CKD would typically be restricted to 2000 mg per day. Each individual is different and should consult their doctor or dietitian for their specific scenario.

  • High potassium foods are > 200 mg Low potassium foods are < 200 mg

Ways to stay under your daily limit

  • Eat lots of different foods in moderation. Just because you can’t eat over a certain amount of potassium doesn’t mean you can’t eat any at all. Your body still needs its nutrition.
  • Always remember to use portion control. A large amount of a low potassium food can quickly turn into a high-potassium situation.
  • Try and limit foods that are > 200 mg per serving. Below is a list of foods that are > 200 mg and also below 200 mg. Along with you doctor or dietitian, our website will provide recipes that limit high potassium foods, or use low potassium foods.
  • Some high potassium foods can be leached. 
  • Potassium leaching is a simple method used to ‘leach’ out some, or the majority, of potassium.
  • If you are on dialysis, be sure to get all the treatment or exchanges prescribed to you.
  • Potassium is not always on nutritional labels. Always do some research of your own. We are very fortunate to have lots of answers at our finger tips. If you don’t see potassium on the food label, just look it up quickly.

Random fact: Dried apricots have the highest concentration of potassium by weight of any food.

High-Potassium Foods > 200 mg

The portion size is ½ cup unless otherwise stated. 

Fruits

  • Apricot, raw (2 medium)
  • dried (5 halves)
  • Avocado (¼ whole)
  • Banana (½ whole)
  • Cantaloupe 
  • Dates (5 whole)
  • Dried fruits 
  • Figs, dried 
  • Grapefruit Juice 
  • Honeydew 
  • Kiwi (1 medium) 
  • Mango (1 medium) 
  • Nectarine (1 medium) 
  • Orange (1 medium) 
  • Orange Juice 
  • Papaya (½ whole) 
  • Pomegranate (1 whole) 
  • Pomegranate Juice 
  • Prunes 
  • Prune Juice 
  • Raisins
Vegetables

  • Acorn Squash
  • Artichoke 
  • Bamboo Shoots 
  • Baked Beans 
  • Butternut Squash 
  • Refried Beans 
  • Beets, fresh then boiled  
  • Black Beans  
  • Broccoli, cooked 
  • Brussels Sprouts 
  • Carrots, raw 
  • Chickpeas (1 cup) 
  • Chinese Cabbage 
  • Dried Beans and Peas 
  • Greens, except Kale 
  • Hubbard Squash 
  • Kohlrabi 
  • Lentils 
  • Legumes 
  • White Mushrooms, cooked (½ cup) 
Other Foods

  • Bran/Bran products  
  • Chocolate (1.5-2 ounces)  
  • Granola  
  • Milk, all types (1 cup)  
  • Molasses (1 Tablespoon)  
  • Nuts and Seeds (1 ounce)  
  • Peanut Butter (2 tbs.)  
  • Salt Substitutes/Lite Salt  
  • Salt Free Broth  
  • Yogurt  
  • Snuff/Chewing Tobacco  

Low-Potassium Foods < 200 mg

The portion size is ½ cup unless otherwise stated. 

Fruits

  • Apple (1 medium) 
  • Apple Juice 
  • Applesauce 
  • Apricots, canned in juice 
  • Blackberries 
  • Blueberries 
  • Cherries 
  • Cranberries 
  • Fruit Cocktail 
  • Grapes 
  • Grape Juice 
  • Grapefruit (½ whole) 
  • Mandarin Oranges 
  • Peaches, fresh (1 small) canned (½ cup) 
  • Pears, fresh (1 small) canned (½ cup) 
  • Pineapple 
  • Pineapple Juice 
  • Plums (1 whole) 
  • Raspberries 
  • Strawberries 
  • Tangerine (1 whole) 
  • Watermelon (limit to 1 cup
Vegetables

  • Alfalfa sprouts 
  • Asparagus (6 spears raw) 
  • Beans, green or wax
  • Broccoli (raw or cooked from frozen) 
  • Cabbage, green and red
  • Carrots, cooked 
  • Cauliflower 
  • Celery (1 stalk) 
  • Corn, fresh (½ ear) frozen (½ cup) 
  • Cucumber 
  • Eggplant 
  • Kale 
  • Lettuce 
  • Mixed Vegetables 
  • White Mushrooms, raw (½ cup) 
  • Onions 
  • Parsley 
  • Peas, green 
  • Peppers 
  • Radish 
  • Rhubarb 
  • Water Chestnuts, canned 
  • Watercress 
  • Yellow Squash  
  • Zucchini Squash 
Other Foods

  • Rice  
  • Noodles  
  • Pasta  
  • Bread and bread products (Not Whole Grains)  
  • Cake: angel, yellow  
  • Coffee: limit to 8 ounces  
  • Pies without chocolate or high potassium fruit  
  • Cookies without nuts or chocolate  

Leaching Potassium from Vegetables

Leaching is the process of pulling potassium out of certain vegetables using water. It’s important to remember that leaching will help pull some potassium out of high-potassium vegetables, but not all of the potassium. Leaching vegetables does not mean you have free range to eat as much as you want. After leaching potassium from your vegetables you must still limit how much you eat. Remember to always ask your dietitian or doctor about the amount of leached vegetables that’s safe to have in your diet.

Old and commonly used method to leach vegetables:

For Potatoes, Sweet Potatoes, Carrots, Beets, Winter Squash, and Rutabagas:

  1. Peel and place the vegetable in cold water so they won’t darken.
  2. Slice vegetable 1/8 inch thick.
  3. Rinse in warm water for a few seconds.
  4. Soak for a minimum of two hours in warm water. If soaking longer, change the water every four hours.
  5. Rinse under warm water again for a few seconds.

A Study Was Conducted:

“Jerrilynn D. Burrowes, PhD, RD & Nicholas J. Ramer, PhD conducted a study to measure the amount of potassium loss in tuberous root vegetables using different methods. The tuberous root vegetables used in the study were: fresh and sweet batata, cocomalanga, dasheen, eddo, black yam, white yam, yellow yam, yampi, malanga, red yautia, white yautia, and yuca. These are not the most common vegetables in the world, but they chose these because of their high fibrous density. Why? Well if you can reduce the potassium in these vegetables, then the same techniques will apply to the softer more porous vegetables.

Five experiential environments were created using varying soak times and cooking methods, and they analyzed the potassium levels of each vegetable using atomic absorption spectrophotometry (= fancy technical term), and the residue of dried vegetables.

The results were very interesting – what Burrowes & Ramer discovered was that the traditional and most common method of leaching potassium from vegetables wasn’t worth your time at all! There was virtually no difference between soaking these vegetables and not soaking them. What they did find out which is of interest, is that double cooking (double boiling) is the only sure way to reduce potassium levels significantly in most vegetables. One round of boiling helps, but the clear winner was the double cooking method.” – http://www.kidneycoach.com/

New and improved method to leach vegetables:

  • Peel the vegetable, slice into small pieces (roughly 3mm width).
  • Wash the vegetables thoroughly, and rinse.
  • Fill a pot of water and place the vegetables within to boil (2:1 ratio / water:vegetables).
  • Bring to the boil, and then drain water off.
  • Fill pot again with water (2:1 ratio), and boil until soft, but integrity is retained.
  • And you’re done!

Sources: