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:

• Up to 4 % DV = 0-140 mg, low potassium
• Up to 7 % DV = 141-250 mg, medium potassium
• Up to 14% DV = 251-500 mg, high potassium
• 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.

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.

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.

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

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.

• 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 the potassium content. For example a recipe for Glazed Chicken and Vegetables, the main entree for a meal, contains 450 mg potassium. This is considered acceptable for a diet limited to 2000 mg potassium a day because the recipe provides a main portion of the meal. Additional low potassium sides like rice, blueberries and sourdough bread complete the meal without exceeding 1/3 of the daily potassium goal.

A medium banana at 400 mg potassium is considered high in potassium, since it is only a small portion of the daily intake. A few banana slices or 1/3 piece is a more reasonable portion of banana for a lower potassium diet.

Learning which foods are high and low in potassium is a first step in understanding the best way to eat on a low potassium diet.

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.

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:

http://www.davita.com/diet-and-nutrition/c/diet-basics