Po…Pot…Potassium? What’s that?

Here’s hoping you had a wonderful Christmas – if that’s what you celebrate – and/or Chanukah, Kwaaza or a holiday I don’t know about yet.  Everyone’s financial situation was so tight this year that I was told repeatedly, “I have never spent so little on gifts as I did this year,” or “I can’t afford any gifts. I’ll have to come up with some other ideas.”  And this year was the year that these same people gave the most thoughtul, creative and inspired gifts. From the letter telling me how my step-daughter felt about me to the afternoon spent with my daughter and all the thoughtful, really thoughtful gifts inbetween, if this is how a no-money gifting season goes, I wish we’d treat every year this way – whether or not there was money available.  Tissue alert: With my four daughters – step and biological – and my fiance, “I don’t need no stinkin’ gifts.” (Thank you, “Treasure of Sierra Madres” for the almost quote.)

Okay, you can put the tissues away again.  We did visit and go out to restaurants a bit.  This time I heard another question several times: “What’s with you and potassium?”  Just as I was framing an original post on this very subject, The National Kidney Foundation posted their potassium fact sheet.  Nothing like learning from the masters!

On Potassium and Your CKD Diet

What is potassium and why is it important to you?

Potassium is a mineral found in many of the foods you eat. It plays a role in keeping your heartbeat regular and your muscles working right. It is the job of healthy kidneys to keep the right amount of potassium in your body. However, when your kidneys are not healthy, you often need to limit certain foods that can increase the potassium in your blood to a dangerous level. You may feel some weakness, numbness and tingling if your potassium is at a high level. If your potassium becomes too high, it can cause an irregular heartbeat or a heart attack.

What is a safe level of potassium in my blood?

Ask your doctor or dietitian about your monthly blood potassium level and enter it here:

If it is 3.5-5.0………………………You are in the SAFE zone
If it is 5.1-6.0………………………You are in the CAUTION zone
If it is higher than 6.0……………..You are in the DANGER zone

How can I keep my potassium level from getting too high?

  • You should limit foods that are high in potassium. Your renal dietitian will help you plan your diet so you are getting the right amount of potassium.
  • Eat a variety of foods but in moderation.
  • If you want to include some high potassium vegetable in your diet, leach them before using. Leaching is a process by which some potassium can be pulled out of the vegetable. Instructions for leaching selected high potassium vegetables can be found at the end of this fact sheet. Check with your dietitian on the amount of leached high potassium vegetables that can be safely included in your diet.
  • Do not drink or use the liquid from canned fruits and vegetables, or the juices from cooked meat.
  • Remember that almost all foods have some potassium. The size of the serving is very important. A large amount of a low potassium food can turn into a high- potassium food.
  • If you are on dialysis, be sure to get all the treatment or exchanges prescribed to you.

What foods are high in potassium (greater than 200 milligrams per portion)?

The following table lists foods that are high in potassium. The portion size is ½ cup unless otherwise stated. Please be sure to check portion sizes. While all the foods on this list are high in potassium, some are higher than others.

High-Potassium Foods
Fruits Vegetables Other Foods
Apricot, raw (2 medium)
dried (5 halves)
Acorn Squash Bran/Bran products
Avocado (¼ whole) Artichoke Chocolate (1.5-2 ounces)
Banana (½ whole) Bamboo Shoots Granola
Cantaloupe Baked Beans Milk, all types (1 cup)
Dates (5 whole) Butternut Squash Molasses (1 Tablespoon)
Dried fruits Refried Beans Nutritional Supplements:
Use only under the
direction of your doctor
or dietitian.
Figs, dried Beets, fresh then boiled
Grapefruit Juice Black Beans
Honeydew Broccoli, cooked Nuts and Seeds (1 ounce)
Kiwi (1 medium) Brussels Sprouts Peanut Butter (2 tbs.)
Mango (1 medium) Chinese Cabbage Salt Substitutes/Lite Salt
Nectarine (1 medium) Carrots, raw Salt Free Broth
Orange (1 medium) Dried Beans and Peas Yogurt
Orange Juice Greens, except Kale Snuff/Chewing Tobacco
Papaya (½ whole) Hubbard Squash  
Pomegranate (1 whole) Kohlrabi  
Pomegranate Juice Lentils  
Prunes Legumes  
Prune Juice Mushrooms, canned  
Raisins Parsnips  
  Potatoes, white and sweet  
  Spinach, cooked  
  Tomatoes/Tomato products  
  Vegetable Juices  

What foods are low in potassium?

The following table list foods which are low in potassium. A portion is ½ cup unless otherwise noted. Eating more than 1 portion can make a lower potassium food into a higher potassium food.

Low-Potassium Foods
Fruits Vegetables Other Foods
Apple (1 medium) Alfalfa sprouts Rice
Apple Juice Asparagus (6 spears) Noodles
Applesauce Beans, green or wax Pasta
Apricots, canned in juice Cabbage, green and red
Carrots, cooked
Bread and bread products: (Not Whole Grains)
Blackberries Cauliflower Cake: angel, yellow
Blueberries Celery (1 stalk) Coffee: limit to 8 ounces
Cherries Corn, fresh (½ ear)   frozen (½ cup) Pies without chocolate or high potassium fruit
Cranberries Cucumber Cookies without nuts or chocolate
Fruit Cocktail Eggplant Tea: limit to 16 ounces
Grapes Kale  
Grape Juice Lettuce  
Grapefruit (½ whole) Mixed Vegetables  
Mandarin Oranges Mushrooms, fresh  
Peaches, fresh (1 small) canned (½ cup) Okra  
Pears, fresh (1 small) canned (½ cup) Onions  
Pineapple Parsley  
Pineapple Juice Peas, green  
Plums (1 whole) Peppers  
Raspberries Radish  
Strawberries Rhubarb  
Tangerine (1 whole) Water Chestnuts, canned  
Watermelon (limit to 1 cup) Watercress
  Yellow Squash  
  Zucchini Squash  

How do I get some of the potassium out of my favorite high-potassium vegetables ?

The process of leaching will help pull potassium out of some high-potassium vegetables. It is important to remember that leaching will not pull all of the potassium out of the vegetable. You must still limit the amount of leached high-potassium vegetables you eat. Ask your dietitian about the amount of leached vegetables that you can safely have in your diet.

How to leach vegetables.

For Potatoes, Sweet Potatoes, Carrots, Beets, 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. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  5. Rinse under warm water again for a few seconds.
  6. Cook vegetable with five times the amount of water to the amount of vegetable.

For Squash, Mushrooms, Cauliflower, and Frozen Greens:

  1. Allow frozen vegetable to thaw to room temperature and drain.
  2. Rinse fresh or frozen vegetables in warm water for a few seconds.
  3. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  4. Rinse under warm water again for a few seconds.
  5. Cook the usual way, but with five times the amount of water to the amount of vegetable.

Bowes & Church Food Values of Portions Commonly Used, 17th Ed., Pennington, JA, Lippincott, 1998.
Diet Guide for Patients with Kidney Disease, Renal Interest Group-Kansas City Dietetic Association, 1990.

The National Kidney Foundation would like to thank the
        Council on Renal Nutrition for the development of this fact sheet.

[Me: This is a bit different from my renal diet.  There are foods on here that my diet doesn’t allow, but you’ll see when you look at your diet that most foods we need to concern ourselves with are mentioned on this list.]

On the book front, don’t forget the Twitter Chat on Jan. 9 from 8-9 EST.  Locals, come on down to Bookman’s in Mesa on Jan. 14 from 1-3 for a book signing.  Oh, KevinMD.com will be running an excerpt from the book within the next week and a half or so.  I’ll send out a bulletin when I find out the exact date.  My new year is already looking pretty bright.  That’s what I wish for you: a happy, healthy new year with lots of whatever you desire in it.

Until next week (which will actually be next year),

Keep living your life!