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FACT SHEET FOR PATIENTS AND FAMILIES

Kidney Disease and Potassium

What is potassium and why is it important? What do I need to do next?

Potassium is a found in many . When 1 Get regular blood tests to check the it’s at the correct level in your body, potassium helps potassium level in your body. your muscles work properly and keeps your 2 Try to eat low-potassium foods. Check page 2 beating evenly. and page 3 to find out the potassium levels in common foods. How does disease 3 Review the tips on how to follow a low- affect potassium? potassium diet and manage your potassium level (see page 4). Potassium usually stays at the right level if your kidneys are healthy. Unfortunately, kidney disease can cause you to have too much potassium in your body. Here’s why: Potassium zones • • With kidney disease, your kidneys don’t remove You’ll have regular blood tests to check the enough potassium. potassium in your blood. Your healthcare provider will tell you which of the following •• Some medications that treat kidney disease may zones you’re in and what you’ll need to do: cause your potassium level to go up. DANGER What happens if I have too zone much potassium in my body? CAUTION zone Too much potassium can be dangerous. It can cause: • SAFTEY • zone •• Numbness or tingling •• A slow or irregular heartbeat •• Sudden death due to a stopped heart If you have kidney disease, you’ll need regular blood tests to check the amount of potassium in your 3.5 to 5.0 5.1 to 6.0 over 6.0 blood. If your potassium level is too high, you’ll need mmoI/L mmoI/L mmoI/L treatment to lower it. See the “Potassium zones” box (at right) for more information.

1 Potassium in common foods Limit foods that are high in potassium, and choose foods that are low in potassium. The table below and on page 4 shows the potassium levels in common foods. A serving is a ½ cup unless a different serving size is listed. Foods listed in the “GO!” column in bold type have the lowest potassium — less than 200 milligrams (mg) per serving.

Very high WHOA! High SLOW Low GO! potassium potassium potassium (more than 400 mg — (200 to 400 mg — (less than 200 mg — Category LIMIT these) WATCH portion sizes) CHOOSE these instead)

•• •• (fresh, canned) •• Apples, applesauce, •• (canned) •• Honeydew melons and nectar and apple •• Lemons and •• juice •• Apricots (dried, ¼ cup) •• Berries: lemon juice Blackberries, • Papaya •• Cantaloupe •• Lychee • blueberries, • Dates (¼ cup) • Mandarin oranges •• Prunes and • cranberries • prune juice •• Figs (dried) (¼ cup) (craisins), •• Peaches (fresh •• Guava raspberries, or canned) •• Jackfruit (raw) strawberries, and •• Pears (fresh Fruits and berry or canned) fruit juices •• Kiwi •• Cherries and •• Pineapple •• Mango cherry juice •• Plums •• Nectarine •• Figs (fresh) •• Rambutan (canned • Orange • •• Fruit cocktail and drained) •• Pomegranate and •• Grapefruit and •• Rhubarb pomegranate juice grapefruit juice •• Tangerines •• Raisins (¼ cup) •• Grapes and •• Watermelon grape juice

•• •• Artichoke •• •• Leafy : •• Bamboo shoots (raw) •• Beets and beet greens •• Bamboo shoots Chard (fresh), collards, , • Beans (canned • Bok choy (canned) • • turnip, mustard, or dried white • Broccoli •• Brussels sprouts • (fresh) beans, black beans, • Celery (cooked) •• garbanzos, kidney • •• (fresh) •• Cactus (nopales) beans, pinto beans) •• Chili peppers •• Onions and •• Carrots •• Chinese cabbage •• Greens: Spinach radishes (cooked), chard •• Cauliflower Vegetables •• Potatoes (white and •• Peas (including (cooked), beet greens and sweet potatoes, •• Celery (fresh) snap peas, vegetable french fries, and •• •• Cucumber snow peas) juices chips) •• Mushrooms (canned) •• Eggplant •• Seaweed (dried) •• Squash (winter •• Pumpkin •• Endive •• Spaghetti squash squashes like •• Root vegetables •• beans •• Sprouts Hubbard or ) ( and rutabaga) (, bean) •• Green peppers •• Tomato products •• Tomatoes or •• Squash (zucchini, • Iceberg lettuce (including tomato tomato juice • yellow squash) paste, marinara sauce) •• Okra •• Vegetable juice cocktail •• chestnuts •• Yucca, cassava, taro

2 Very high WHOA! High SLOW Low GO! potassium potassium potassium (more than 400 mg — (200 to 400 mg — (less than 200 mg — Category LIMIT these) WATCH portion sizes) CHOOSE these instead)

•• Cream, half-and-half •• Soy , vanilla, or •• Cottage cheese (1 cup) •• Milk: Regular, skim, plain (1 cup) •• Hard cheese and processed cheese (1 ounce) Dairy 2%, , •• Yogurt (1 cup) •• Rice milk (unenriched) buttermilk (1 cup) •• Soymilk, chocolate A shaker next to an •• Canned beans •• Beef, pork, veal Eggs (2) item means it’s high in (salt). To reduce •• Dried peas and beans (3 ounces) Meats sodium, limit those foods. • Lentils •• Fish (3 ounces) and meat • •• Nuts and seeds •• substitutes (2 tablespoons) •• Poultry (3 ounces)

•• Bran, bran cereals, •• Air-popped popcorn breads made with bran •• Bread, crackers, noodles, pasta, or tortillas Breads and •• Granola made with white (refined) flour grains •• Bread, crackers, noodles, pasta, or tortillas made with whole flour •• White rice

Salad dressings (some) •• Butter, margarine, and and — check the label and •• Mayonnaise and mayo-like spreads oils ingredient list

•• Chocolate •• Ice cream with no •• Cakes, cookies, and pies made •• Candy with chocolate chocolate or nuts without chocolate or high-potassium fruits Sweets, or nuts (1 cup) or vegetables desserts, •• Ice cream with nuts or •• (1 tablespoon) •• Candy (hard candies, gumdrops, jelly beans) and chocolate (1 cup) •• Ice pops, jello sweeteners •• Nuts •• Jam and jelly, maple syrup •• Sugar (white), corn syrup, honey

•• Hot chocolate (1 cup) •• Carbonated drinks •• Milk and other •• Drinks from powdered crystals Drinks dairy drinks •• Lemonade •• Coffee or tea (1 cup)

•• Low-sodium •• Corn starch, regular baking powder Spices, •• Herbs and spices •• Salt substitutes (some) •• Mustard flavorings, — check the label and other •• Sauces and sauce mixes •• Low-sodium soups • Vanilla and other flavorings ingredients and sauces (some) — • check the label •• Vinegar

3 How can I manage potassium? Tips on limiting potassium To keep your body’s potassium at a healthy level or to Sometimes a low-potassium diet can feel complicated. lower it if your level is too high: Here are some tips for following a low-potassium diet:

•• Talk to your doctor about ALL the medications •• Focus most on limiting very high-potassium you take, including over-the-counter foods (see page 3 and page 4). Most foods have medications, supplements, and herbal some potassium, but avoiding or limiting high- remedies. Some of these, including over-the- potassium foods is very important. counter pain relievers and , might increase •• Limit milk and dairy items to 1 cup each day. your potassium level. •• Limit high- items to 3 ounces per •• Limit high-potassium foods in your diet. See meal. A deck of cards is a good reference for the page 2 and page 3 to discover the potassium levels serving size of meats. in many common foods. •• If you eat canned fruit, don’t drink the juice in •• Watch serving sizes. Even with low-potassium the can. Drain the juice from all canned fruits and foods, an extra-large serving can give you too vegetables, and don’t cook canned vegetables in much potassium. their juice.

•• Avoid the use of salt substitutes. Potassium •• Set reasonable limits. If your potassium level is chloride is often used in place of less than 5 mmol/L, it’s okay to have one or two (table salt) to make food items more “heart- higher-potassium foods. Just have a very small healthy.” Check all “ingredient lists” for potassium amount. For example: chloride and avoid these foods. –– Have a few small chunks of cantaloupe in a fruit •• Talk to your nephrologist if you have excessive salad, but don’t eat a full slice of cantaloupe. or . These can affect the –– Have a thin slice of tomato on a sandwich, but potassium levels in your body. don’t have a tomato sandwich. •• Don’t “stack” several high potassium foods in a single meal or on the same day. Help from a Registered For example, Dietitian Nutritionist don’t have , bran cereal, and a for breakfast.

Talk with your doctor about whether seeing a Registered Dietitian Nutritionist (RDN) would be helpful for you. Can my potassium ever get too low? An RDN can help you create an eating plan If you have kidney disease it’s uncommon to based on your diet restrictions and what you have potassium that’s too low, but it’s possible. like to eat. Help from an RDN may be especially useful if you’re on several dietary restrictions. If blood tests show that your potassium level is too low, your healthcare provider will tell you To learn more and contact an RDN, visit: what to do. You can usually add high-potassium intermountainhealthcare.org/nutrition foods back into your diet, at least until your potassium levels are back to normal.

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