The Daily Value (DV) on food labels was established for the general public to help determine if a food is a high or low source of specific nutrients.
For people with healthy kidneys a high potassium intake is considered healthy. The daily goal is to consume enough high potassium foods to provide at least 3500 mg potassium.
Once the kidneys can no longer remove potassium (usually in later stage 4 and stage 5 CKD), and blood potassium values rise above normal (3.5-5.0 mEq/L) a lower potassium diet is usually prescribed.
Some but not all foods include potassium on the Nutrition Facts Label. An understanding of what to look for can help make grocery shopping easier. Here’s a general potassium DV guideline to help interpret the numbers when reading food labels:
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Up to 4 % DV = 0-140 mg, low potassium
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Up to 7 % DV = 141-250 mg, medium potassium
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Up to 14% DV = 251-500 mg, high potassium
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Over 20% DV = 700 mg or more, very high potassium
Each person has individual requirements for potassium depending on kidney function, lab values, appetite and type of dialysis treatment. It’s a good idea for people with chronic kidney disease to always check with their kidney care team rather than guess about their diet requirements for potassium.
Potassium restriction is not required by all people with chronic kidney disease (CKD). Usually those on hemodialysis or in late stage kidney failure, but not yet on dialysis are prescribed a lower potassium diet by their doctor or dietitian. People with early stage chronic kidney disease or daily dialysis may require a more liberal potassium intake unless their lab values are high.
This is often confusing when first diagnosed with CKD. Doctors and dietitians monitor potassium lab values to determine when their patient needs to start limiting foods high in potassium. As kidney function declines, more potassium is retained in the blood, so dietary intake must be reduced to prevent high potassium levels. Too much potassium is dangerous and can cause heart failure.
People who are unsure can check with their kidney doctor and dietitian to confirm an individual daily goal for potassium as well as other diet parameters.
Listing potassium on food labels is optional for food manufacturers. Dialysis patients be aware that just because potassium is not listed on the label, it does not mean the food is potassium free.
Potassium is plentiful in milk, meats, fruits, vegetables, beans and nuts. If these ingredients are in the food, it contains potassium.
Another potassium source to be aware of is potassium chloride, the main ingredient in salt substitute. Some manufactured low-sodium food products contain potassium chloride instead of salt. Avoid this ingredient for a low potassium diet because a single teaspoon contains 2800 mg potassium.
Currently, the FDA is studying revision of nutrients required on food labels. (Docket No. 2006N-0168, titled Food Labeling: Revision of Reference Values and Mandatory Nutrients). People with CKD will benefit if potassium and phosphorus are added to the revised nutrition label.
Kidney Diet Tips has a new home at http://kidneydiettips.davitablogs.com
Please note the change in your Bookmarks or Favorites. This new address provides a direct connection to DaVita.com and their many resources on kidney disease.
Eggplant, also known as aubergine, is a great vegetable choice for kidney diets because it is low in potassium, sodium and phosphorus. One cup of steamed eggplant contains 2 mg sodium, 167 mg potassium and 17 mg phosphorus.
Some cooks soak eggplant in salted water to help remove air. This treatment decreases the amount of oil or water soaked up by the eggplant during cooking. For a low sodium diet avoid this step to keep sodium content at a minimum.
A fresh, ripe eggplant is shiny, and the flesh will bounce back when pressure is applied. Overripe eggplant becomes bitter and the skin toughens. When selecting eggplant, look for the dimple at the blossom end and choose eggplants with an oval shaped dimple instead of the round shaped dimple—it will have fewer seeds.
There are many ways to prepare eggplant. Try marinating sliced eggplant in herbs, lemon and olive oil, then cook it on the grill. Stuff eggplant with a ground meat, rice and seasonings and bake it in the oven. Dip eggplant slices in egg whites then breadcrumbs and fry it in oil. Stir-fry eggplant in peanut and sesame oil blend, and season with a dash of reduced sodium soy sauce or hoisin sauce.
Check out these kidney friendly eggplant recipes onDaVita.com:
Eggplant Casserole Garlicy Ginger Eggplant Eggplant with Meatballs Eggplant Seafood Casserole
Breads can be a source of confusion for dialysis patients or CKD non-dialysis patients who require phosphorus restriction. Refined white bread (made from wheat flour) is generally low in phosphorus and potassium. The more bran and whole grains in bread, the greater the potassium and phosphorus content (and higher fiber content). A soft wheat bread that does not contain whole grain is acceptable for most kidney diets limited in potassium and phosphorus. Often soft wheat breads contain molasses to give the brown color. In deciding which one, consider how many slices you would consume (a whole sandwich vs. one slice) and if potassium and phosphorus levels are normal or high on monthly blood work.
A fact often overlooked is all breads, regardless or being refined or whole grain, provide a significant amount of sodium, around 130 mg or more per slice. It adds up for those who eat 3 or more slices of bread a day. Compare labels and look for low sodium breads as an alternative. Checkout size of the bread slices too–thicker slices are generally provide more minerals than thin slices.
Check with the renal dietitian for guidance on including whole grain bread if you choose it over refined bread. Guidelines for how often and how much to include each day are helpful.
Here’s a comparison of wheat breads:
1 slice white bread: 25 mg potassium, 25 mg phosphorus sodium, 150 mg, fiber 0.6 grams
1 slice soft wheat bread: 46 mg potassium, 39 mg phosphorus, sodium 130 mg, fiber 0.9 grams
1 slice whole grain bread: 70 mg potassium, 57 mg phosphorus, sodium 130 mg, fiber 1.9 grams
Dairy Delicious Milk™ is low potassium, low phosphorus real milk, treated by a demineralization process. It’s produced by Delicious Milk Company. I like this company because they help kidney patients stick to their diets by providing a kidney-friendly version of milk and cheese. Dairy foods are limited and terribly missed when a low potassium, low phosphorus diet is required for dialysis or CKD non-dialysis patients.
Delicious Milk Company also makes a low phosphorus, low sodium Cheddar Cheese Sauce. I’ve tasted the milk and cheese sauce and found both to be tasty and very acceptable. Two additional products available soon include Macaroni and Cheese Dinner and Ricotta Cheese reduced in phosphorus.
Products are available in selected grocery stores (listed on the website) or by mail or phone 877-432-4797. For more information visit the website at www.dairydelicious.com.
Potassium isn’t always available on the food label or in a recipe, but when it is listed, what do the numbers mean? Here’s a general potassium guideline for interpreting potassium when available in a recipe (always check with your renal dietitian for individual guidelines):
- Very low potassium: below 35 mg per serving
- Low potassium: below 150 mg per serving
- Medium potassium: 150 to 250 mg potassium per serving
- High potassium: above 250 to 500 mg potassium per serving
- Very high potassium: above 500 mg potassium per serving
A consideration is how much of the food will be consumed in relation to Continue Reading »
Potassium content is often difficult to find on food labels or in recipes. Exceptions include cookbooks and websites specifically for chronic kidney disease or dialysis patients (see Kidney Diet Tips blogroll).
Another recipe source with potassium analysis I’ve discovered is a cooking magazine called Eating Well.
All the recipes in this publication include nutrient analysis for potassium as well as protein and sodium. Phosphorus is the only nutrient not included that would be useful to kidney patients. You can pick up a copy of Eating Well magazine at your local store, or go online to view recipes at www.eatingwell.com (some of the older online recipes may not include potassium yet).
Keep in mind, Eating Well magazine recipes are not developed for the kidney diet. Recipes vary from low to high potassium and phosphorus analysis is not available. Some of the recipes can easily be modified to reduce phosphorus content. People who want assistance with modifying recipes for a kidney diet can ask their Renal Dietitian for help.
Are you looking for more information on nutrition and diet for late stage kidney disease or dialysis? The National Kidney and Urologic Diseases Information Clearinghouse has two publications of interest:
Nutrition for Later Chronic Kidney Disease in Adults
http://kidney.niddk.nih.gov/kudiseases/pubs/NutritionLateCKD/index.htm
Eat Right to Feel Right on Hemodialysis
http://kidney.niddk.nih.gov/kudiseases/pubs/eatright/index.htm
In addition, DaVita.com has many articles on diet and nutrition for kidney disease:
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