Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes

This dietary advice sheet provides general information to help you change your diet. If you want more detailed advice or are following other dietary restrictions and need guidance, please ask your doctor to refer you to a registered dietitian.

Potassium and phosphate are minerals found naturally in foods and are present in the blood. In kidney disease, the amounts of potassium and phosphate in your blood can rise. This can be harmful to your health. The following advice will help you to choose lower potassium and phosphate foods while still following a varied, enjoyable diet that is suitable for your diabetes. If you need more detailed advice please contact a dietitian.

Foods to limit Foods to choose Dairy Condensed and evaporated milks Eggs, up to 4 per week; milk, 200ml Products: Processed cheese spread e.g. (⅓ pint) per day; Yoghurts/fromage Dairylea, Primula, supermarket own frais, 120g-150g pot 3-4 per week brand cheese spreads (containing less than 10g Cheese containing nuts, Emmental, carbohydrate per 100g); Gruyere, Parmesan, Cheddar, Ice cream, 2 scoops (120g) 2-3 per reduced-fat Cheddar, Edam, Gouda, week; Custard, 150ml (¼ pint) or Red Leicester Milk pudding, 200g (½ tin) 2-3 per week Cheese: maximum 180g (6oz) per week (Brie, Camembert, cottage cheese, cream cheese, Feta, goats cheese, Lancashire, Mozzarella, Quark, ricotta, Roquefort, Stilton). Cream/butter/margarine/Crème Fraiche (in moderation) Meat, Poultry Heart, kidney, liver, liver pâté, oxtail, Bacon, beef, chicken, corned beef, and Fish: tongue, pheasant, pigeon, tinned duck, gammon, lamb, pork, rabbit, meat, ham, sausages Anchovies, fish turkey, veal, venison. paste, fish roe, pilchards, sardines, Cod, haddock, halibut, plaice, sole, scampi, sprats, swordfish, whitebait skate, home-made fish cakes, Note: Cured, smoked and tinned tinned crab, mackerel, mussels, meats and fish are high in salt. shrimps, squid, scallops, whelks, herring, kippers, prawns, salmon and tuna (fresh or canned), trout. Lentils, Pulses Aduki beans, butter beans, pinto Quorn , tofu, hummus, boiled and Meat beans, soya beans lentils alternatives Choose canned beans rather than dried: baked beans, black eye beans, broad beans, chickpeas, red kidney beans

Patient Information leaflet for: Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes Author/s: Renal Dietitians Approved by: PIF Reviewed 17/08/2021 Date approved: 19/08/2021 Review date: 19/08/2022 Available via Trust Docs Version: 3 Trust Docs ID: 14857 Page 1 of 4 Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes

Fruit: Avocado pears, large bananas, Choose 2 servings of fresh or dates, dried apricots, fresh / dried tinned fruit / day figs, grapefruit, melon, nectarines, E.g. one serving of fresh fruit is oranges, pomegranates, prunes, equivalent to: raisins, rhubarb, star fruit and 1 apple / apricot / peach / pear or sultanas ½ small banana / kiwi or 2 Drain natural juice from tinned fruit. clementines / satsumas / plums or 100g (3.5 oz.) raspberries / 8 strawberries or 16 grapes/ 20 cherries /180g (6 oz.) blueberries Vegetables: Do not bake, fry, microwave, roast, Have 2 servings of suitable boiled pressure cook or steam vegetables. vegetables (1 portion = 3-4 Limit Brussel sprouts, mushrooms, tablespoons) or small salad/day: parsnips, spinach Cabbage, carrots, cauliflower, Avoid raw vegetables (except 1 small chickpeas (tinned), French / green salad per day), sundried tomatoes, beans, kale, mange tout, marrow, tomato puree mixed vegetables, peas, pumpkin, Do not use water from boiling runner beans, spring greens, vegetables to prepare soups, stews, swede, sweetcorn, turnip or 2 gravies, casseroles etc. spears of broccoli Tomatoes – 1 small or 4 cherry tomatoes / day Potatoes: Jacket potatoes, potato wedges, Choose up to 150 g (5 oz.) i.e. 3 roast potatoes (including egg-sized peeled and boiled supermarket varieties) & potato potatoes per day i.e. boiled croquettes, potato waffles, hash potatoes, mashed potato, tinned browns. Chip shop and potato. Parboiled roast or supermarket chips shop and parboiled chipped potatoes. Sweet supermarket chips potato (boiled) Breads, Rice and Breads containing nuts, seeds & Bread e.g. brown, white, ciabatta, Pasta: dried fruits. Naan bread. Bulgur pitta, granary bread, bagels, wheat. Chick pea, potato, rye and baguettes, croissants, pancakes. soya flour. Self-raising flour. Brown Yorkshire pudding, couscous, rice, wholemeal pasta. Dumplings, polenta instant/pot noodles, macaroni Plain white rice, basmati, plain cheese pasta. Rice noodles Breakfast Cereals and breakfast/cereal bars Porridge, Puffed wheat, Rice Cereals: containing bran, dried fruit, nuts and Krispies, Special K, Shreddies, seeds, chocolate, coconut e.g. All Cornflakes, Shredded Wheat, Bran, Branflakes, Fruit ‘n’ Fibre, Weetabix (sugar content should be Muesli, Raisin Wheats, Shredded less than ⅓ of the total Wheat Fruitful, Sultana Bran, Choco carbohydrate content) Hoops, Weetabix minis with chocolate, Apricot Wheats, wheat bran Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes

Savoury Some savoury snacks and crisps contain potassium chloride as a Snacks: flavouring. It is advised that you regularly check the label and avoid crisps containing potassium chloride. Individual brands and flavours may vary. Crispbreads, oatcakes, Ryvita. Potato Breadsticks, butter puffs, cream crisp & snacks e.g. Hula Hoops, crackers, rice cakes, corncakes, Quavers, Squares, French Fries, plain popcorn. Matzos, pretzels, Discos, Twiglets, Wheat Crunchies. rusks, water biscuits, wholemeal Popadoms. crackers. Vegetable crisps. Bombay/Oriental Maize, corn, wheat and rice snacks mix, Bhajis, Pakoras, nuts & seeds, not containing Potassium Chloride Tortilla chips e.g. cheese puffs, tortilla chips Biscuits: Biscuits containing chocolate, Plain or semi-sweet biscuits: coconut, dried fruit, nuts & seeds, Digestive, Marie, Rich Tea, Malted treacle or bran. Milk, Nice, Ginger nuts (sugar content should be less than ⅓ of the total carbohydrate content) Cakes, Desserts All cakes, desserts & pastries Plain croissants and Pastries: containing chocolate, coconut, dried Fruit pie/crumble or fresh fruit fruit, nuts, treacle, bran e.g. currant salad (using fruit from allowance) buns, chocolate éclairs, hot cross Sugar-free jelly or sorbet buns, bran muffins, Bakewell tart, custard tarts, Danish pastries. Products containing baking powder e.g. scones. Bread pudding Drinks: Instant coffee, Barista coffees e.g. Tea (including fruit, herbal) espresso, latte, cappuccino, mocha You may choose up to 1 cup filter etc. (including packet mixes).Hot coffee a day chocolate & cocoa, malted drinks Instant coffee alternatives e.g. (e.g. Horlicks & Ovaltine). Bovril, Camp coffee, Caro, Barley Cup Oxo, Marmite Milkshakes & smoothies Light coloured fizzy drinks e.g. Most fruit &/or vegetable juices, cherryade, orangeade, ginger coconut water beer, lemonade. Cordials, High juice squashes, Snapple, squashes, Barley water, flavoured Orangina, water, Tonic water Dark fizzy drinks (e.g. Cola, Dr Choose sugar-free/diet/no-added- Pepper and diet versions). Beer & sugar varieties Lager, cider, sherry, port, Martini, Vermouth, strong ale, stout, wine Spirits and liqueurs e.g. vodka, (including Champagne & sparkling rum, gin, whiskey wine)

Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes

Miscellaneous: Chocolate and chocolate nut spreads (e.g. Garlic, herbs, pepper and

Patient Information leaflet for: Kidney Disease: Controlling your Potassium and Phosphate if you have Diabetes Author/s: Renal Dietitians Approved by: PIF Reviewed 17/08/2021 Date approved: 19/08/2021 Review date: 19/08/2022 Available via Trust Docs Version: 3 Trust Docs ID: 14857 Page 3 of 4 Nutella and supermarket own brands) & spices, curry powder peanut butter Gravy Granules/powder White sauce, cheese sauces, instant Cooking oil (e.g. rapeseed), sauces. olive oil, Meat or yeast extracts e.g. Bovril/Oxo/ Reduced sugar jam, Marmite marmalade, lemon curd Molasses and treacle (limit to max. 1 level Salt substitutes e.g. Lo-Salt, Selora & Solo teaspoon per slice of bread) Tomato ketchup, Brown sauce, Most soups Non-sugar sweeteners and stock cubes. Pot Noodles Mint sauce, tartar sauce & vinegar, pickle Chilli sauce in moderation French dressing, mayonnaise, salad cream Confectionary: Confectionary containing dried fruit/nuts Sugar-free fruit or peppermint Cereal bars, chocolate, fudge, liquorice, sweets marzipan, nougat, peanut brittle, toffee, Sugar free chewing gum caramels, carob.