Potassium and early stage kidney disease

When you discover that you have early stage kidney disease, learning about nutrition and diet is a good starting point. One of the minerals to learn about is potassium and how it is affected by kidney disease. 

Potassium’s most important function is to keep your heart beating. Potassium helps trigger your heartbeat which circulates blood throughout your body. In addition, potassium maintains fluid, electrolyte and pH balance in your body, promotes muscle growth, and sustains a healthy nervous system and brain function.   

It’s a crucial electrolyte that allows your muscles to move easily, lets your brain send nerve impulses throughout your body and helps your kidneys filter blood.  

Healthy kidneys maintain a proper level of potassium. Healthy potassium blood levels are between 3.5 - 5.0 mEq/L. If potassium levels become too high or too low, complications may occur.  

In early stages of kidney disease, potassium levels are usually normal because the kidneys are still able to remove sufficient amounts of potassium. If levels are above normal in stages 1, 2 or 3 chronic kidney disease, your doctor will determine if it is related to medications or other factors, and if you need to make any diet changes. A low potassium diet is not advised if you are maintaining normal potassium levels in early kidney disease. Regular blood work will help your doctor monitor your potassium level. 

As kidney function declines in stages 4 and 5 chronic kidney disease potassium levels in the blood may increase because it is no longer removed in sufficient amounts. At this point you may require a low potassium diet. 

High potassium and kidney disease

When you have kidney disease, the kidneys aren’t as effective at removing excess potassium from the blood. Also, some medications may result in excess potassium retention, rather than it being removed in the urine. High blood potassium is called hyperkalemia. A high potassium can cause the following: 

  • Nausea
  • Weakness
  • Numbness or tingling
  • Slow pulse
  • Irregular heartbeat
  • Heart failure

Low potassium and kidney disease

Potassium is in most foods, and so it is uncommon – especially for people with kidney disease – to experience low potassium (hypokalemia). However, malnutrition, excessive vomiting or diarrhea and taking certain medications, such as diuretics, can cause a potassium deficiency. Some symptoms of low potassium include: 

  • Muscle weakness
  • Cramping
  • Fatigue
  • Confusion
  • Problems with muscle coordination
  • Irregular heartbeat
  • Heart failure

Regular blood tests will allow your doctor to monitor your potassium level when you have kidney disease.  

Get to know your potassium level

When you have kidney disease, your potassium levels will be checked regularly by your doctor. You and your renal dietitian can go over your results to determine whether you need to limit high potassium foods or not.

Low potassium range

Less than 3.5 mEq/L

Normal potassium range

3.5 - 5.0 mEq/L

Elevated potassium range

5.1 - 6.0 mEq/

Dangerous potassium amount

More than 6.0 mEq/L

Low potassium foods

Portion size plays a large role in healthy potassium levels. If you have been advised to limit the potassium in your diet, do not overindulge on low potassium foods. Even though they contain less potassium, if they are eaten in large quantities, the amount of potassium may be more than you should have. The following foods are lower in potassium:

Food Group

Low Potassium Foods

Fruits

Apples, berries, fruit cocktail, grapes, lemon, peaches, canned pears, pineapple, plums, watermelon

Vegetables

Carrots, cabbage, cauliflower, cucumber, eggplant, green beans, lettuce, onion, summer squash, sweet peppers

Dairy

Nondairy creamers, nondairy whipped topping, rice milk (unenriched), sorbet or popsicles

Miscellaneous

Jelly beans, hard candies, plain donuts, popcorn (unsalted), pretzels (unsalted)

High potassium foods

Be aware of your potassium allowance when choosing your meals. Here are some potassium-rich foods to limit or avoid if your diet prescription includes low potassium: 

Food Group

High Potassium Foods

Fruits

Avocado, bananas, cantaloupe, dried fruit, honeydew melon, kiwi, mango, oranges and orange juice, papaya, prune juice

Vegetables

Artichoke, dried beans and peas, pumpkin, potatoes and French fries, spinach (cooked), sweet potatoes, tomatoes and tomato juice, vegetable juices, winter squash

Dairy

Ice cream, milk, yogurt

Miscellaneous

Chocolate, molasses, salt substitute, seeds and nuts

Summary

Potassium is a crucial mineral for the body, but moderation is best when you have kidney disease. Find out your potassium level and make the necessary lifestyle changes, such as substituting lower potassium foods for ones high in if you require a low potassium diet. Use the charts in this article and talk with your renal dietitian on ways you can lower potassium when you’re on the kidney diet.

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