Kidney Coach

The Definitive Guide To Potassium In Kidney Disease

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Let’s get one thing straight, you NEED potassium, even in kidney disease. Further to that, you do not need to run for the hills if a certain food has high potassium levels. Eating a well balanced diet full of fruits and vegetables is a GOOD thing, and may even help you reverse your kidney disease…

Confused because it goes against everything you have read and have been told? Don’t be, there is good reason, and I’ll do my best to explain…

The purpose of this article: to dispel the misconceptions around lowering potassium in kidney disease; detail simple easy to follow steps on how to lower potassium levels naturally through diet and other techniques; to educate you on all things potassium, so the next time you are in front of your doctor you can keep up, and maybe even teach him or her a thing or two.

What Is Potassium And Why Do I Need It?

If you are new to this blog, it is important to know that before I start to get too deep into subject matter, I like first to bring it back a little so I can discuss the fundamentals. This gives you a good frame work to understand some of the principles that I talk about, and allows you to make better judgment calls when I, or your doctor, say something. This allows you to be in control of your health. The way it should be, yes?

What is Potassium?

• Potassium at its most basic level is a soft silvery-white metal (mineral), sharing a very similar chemical structure to sodium. Behind only calcium and phosphorus, it is the most abundant of all the minerals totalling 225 grams of your body weight – that’s the weight of the palm of your hand.
• Potassium is also known as an ‘electrolyte’, due to its ability to be electrically conductive. An important feature in the human body, considering you and I are a network of electrical pulses.
• Potassium naturally occurs in nature, and is present in many foods (see further on for a list of foods).
• Potassium is 19th on the periodic table (K is the chemical symbol for Potassium in Latin)
• Fact: 1/3 of the body’s total energy is required to hold the location of potassium and sodium in and around our cells.
• Note: Normal serum potassium levels are: 3.5 and 5.5 mEq/L (reference range)

Why do I need it?

Our body depends on this mineral for its survival… no potassium, no humans. Amazingly through our evolution we have utilized the earth from which we have sprung to carry out and allow certain functions to occur in the body. You may have heard that potassium is good for the heart, good for muscle contractions, and therefore good for lowering blood pressure, and even that it is beneficial in nerve conduction. All of which are true, but there is so much more that this mineral does for you.

Here is a list of other health benefits and actions of Potassium:

• Regulates pH balance
• Helps to thin the blood
• Maintains water/fluid balance
• Eye health
• Increases secretion of hormones: ADH, FSH and aldosterone
• Regulates blood sugar
• Aids protein synthesis
• Regulates cell permeability
• Acts as a capacitor within our cells to store energy

Want more proof of the necessity of potassium? Here is a list of symptoms that occur due to potassium deficiency.

What are the Symptoms of Potassium Deficiency?

• Kidney damage – yup, weren’t expecting that were you?
• Lung problems
• Rheumatoid arthritis
• Thirst
• Death
• Tachycardia
• Fatigue
• Mental confusion
• Metabolic acidosis
• Bone fragility
• Joint and bone pain
• Edema
• Constipation
• Headaches
• Insomnia
• Abnormal heart beat
• Paralysis
• Muscle weakness

As you can see potassium = good.

The Dilemma: High Potassium Levels In Kidney Disease

Ordinarily the body can absorb, assimilate, and utilise potassium to its heart’s content, and then when finished, excrete this life giving mineral out via the urine. Easy.

However when you have chronic kidney disease, this can POSSIBLY change. For a lot of kidney disease sufferers, just like the myriad of other substances the body could once excrete via the kidneys and urine (creatinine, uric acid, and metabolic wastes), potassium cannot move across the filtering membrane within the kidneys’ nephrons, and cross over into the urine collection “funnels” (renal pelvis) that eventually lead to the bladder.

And because of this inability to “cross-over” and be eliminated, the potassium levels increase within the blood and open the body up to many health problems.

Adverse effects caused by high Potassium Levels:

• Paralysis
• Renal necrosis
• Heart arrhythmia
• Diarrhoea
• Convulsions
• Depression
• Mental confusion
• Tingling
• Kidney failure
• Dehydration
• Adrenal exhaustion
• Weakness
• Fever

But this is not always the case. In fact a LOT of kidney disease patients have normal potassium levels.

Which leads me to this…

Why You Possibly Do Not Need To Listen To Your Doctors

Therefore the most important thing you can do for yourself when treating this condition is to become aware, listen to your body, and track and monitor your blood work like you were a doctor. This is ONLY way you will know who to listen to.

All too often I find doctors are advising their clients incorrectly, and potassium is one of the most common. It has become a ‘throw away’ prescription: “You have kidney disease? Oh, then you must avoid potassium and go on a low potassium diet.”

But this is so not true as you have seen. You only need to reduce potassium levels if you have high potassium levels. Remember potassium is important, so eat potassium foods freely until your blood work says otherwise.

How Do I Reduce High Potassium Levels In My Blood?

OK, you have waited long enough, you have high potassium levels and you want to know what to do about it.

Firstly it is all about eating the right amount of potassium. You cannot completely avoid potassium, not that you want to, so it is a good idea to know the guidelines on eating the correct amount of potassium for your stage of kidney disease; in other words, eat a low potassium diet.

Typically the recommended daily allowance for potassium in a healthy individual is 2 to 5 grams a day (some institutions state 4.7 grams a day). In kidney disease this changes depending on your stage of kidney disease…

Low Potassium Diet: Potassium Recommendations

• Kidney Disease Stages 1 to 2 (eGFR of 60 to 90+): 2 to 5g a day
• Kidney Disease Stages 3 to 4 (eGFR of 20 to 60): 2 to 4g a day
• Kidney Disease Stages 4 to 5 (eGFR of 5 to 20): No more than 2 to 2.5g a day

Remember the above is only a rough guide, so if you have very high levels and you are in only stage 1 or 2 kidney disease then it is prudent to eat a low potassium diet to match your blood potassium levels.

What is a safe level of potassium in my blood?

A better way to eat a low potassium diet is in accordance with your blood potassium levels.

Potassium Reference Range

• Low Range: less than 3.5 mEq/L
• Safe range: 3.5 – 5.5 mEq/L
• Unsafe range: 5.6 – 6.0 mEq/L
• Dangerous: more than 6.0 mEq/L

Normal serum potassium levels are 3.5 to 5.5 mEq/L (though some labs quote a reference range of 3.5 to 5.0), and so if you are slightly over that, try eating no more than 4 grams a day of potassium. If it is at a level of say, 6.0 to 7.0, you definitely should not be eating more than 2 grams a day until your high potassium levels have been corrected.

Although this can be a challenge, eating a low potassium diet is probably the easiest, and single most important way to reduce blood potassium levels – so it is definitely worth the effort.

Potassium Content Food List – Low Potassium Diet

Below is a list of common foods that have been organised under ‘low potassium’ or ‘high potassium’. This is just a quick a quick guide and therefore does not contain all foods, nor does it contain the amount of potassium contained within each food. For a more in-depth food list, plus the amount of potassium contained within, please refer to the end of this article for your Free Potassium Food List to download.

Fruits and Vegetables
Low potassium
• blueberries
• grapes
• grapefruit
• strawberries
• green beans
• cauliflower
• cucumbers
• lettuce

Moderate potassium
• apple
• cherries
• pear
• apricot
• pineapple juice
• peaches
• carrots
• peppers
• eggplant
• pumpkin
• radishes
• asparagus
• corn

High potassium
• bananas
• orange
• kiwi
• nectarine
• dried fruits
• papaya
• prune
• avocado
• apricots
• coconut
• potato
• broccoli
• spinach
• tomato
• artichokes
• greens
• winter squash
• yams
• plaintains
• prune juice

Breads and Grains
Low potassium
• plain bagel
• white bread
• oatmeal
• plain pasta
• white rice

Moderate potassium
• bran bread
• muffins and cereals
• whole wheat and pumpernickel bread
• rolls
• crackers
• corn tortilla
• oat and granola cereals


Low potassium
• sour cream

High potassium
• milk and yogurt


Meat, Fish, Poultry

Moderate potassium
• beef
• poultry
• pork
• veal
• eggs


High potassium
• pinto bean
• soy products
• dried beans and peas
• nuts
• fish
• imitation bacon bits


Why Avoiding Fruits and Vegetables Maybe The End Of You

After glancing over the above list of foods, it would seem very logical to decide that fruits and vegetables need to be avoided for your health to improve, heck even your doctor has probably told you this enough. But I can assure you this is madness. But not only that, it is this belief that is keeping you from getting well!

OK so hear me out… Fruit and vegetables are healthiest foods available, packed with healing vitamins and minerals; we all know this, ask any kid. *Potassium aside* So why would you ever dream of cutting these foods out altogether, and live off empty foods, such as rice, pasta, breads (empty foods= non nutrient dense foods)?

“Phytonutrients in specific plant foods are some of the most powerful biological response modifiers scientists have yet discovered.” (Jeffrey Bland Ph.D.) Phytonutrients can be defined as plant derived nutrients.”

And secondly fruits and vegetables are also chock-full of phytonutrients. Phytonutrients can be defined as: chemical compounds such as isoflavones that occur naturally in plants. Plants produce these substances for various reasons, including, structure, chemical messengers, protection from harmful organisms or insects or even attracting pollinating insects. Once eaten by humans though, these substances take on a new role. Using isoflavones as an example, isoflavones can balance the female hormonal system and protect them from breast cancer.

Convinced yet? No? How about the people who have cured themselves from kidney disease using juicing alone! (Albeit rarely)

Great I have got your attention? My point with all this is this: eat a well balanced diet using healthy foods, do not forgo foods that are high in potassium, most of these are the very foods that can help heal you and reverse your condition. Just make sure when you do eat them, that you factor the potassium content in for the day. Great!

11 More Quick Tips To Reduce Potassium Levels

1. Consult your naturopath, dietician, or doctor, and get them to do all the hard work and get them to devise a plan for you.

2. Speak to your doctor about your current medications. Certain medications can increase serum potassium levels, for example: nonsteroidal anti-inflammatory drugs, ACE inhibitors, angiotensin II receptor blockers (ARBs), and potassium sparing diuretics.

3. Keep a food diary for 8 weeks; keep note and monitor your daily intake of potassium. By the end of 8 weeks (or sooner) you will know what to eat without this aid, and have a sense of freedom as you live day by day.

4. Fresh is best, but when you are using canned fruits and vegetables always drain the liquid.

5. Avoid salt substitutes as they commonly use potassium salt (potassium chloride) as an alternative.

6. Read food labels. Especially ‘low salt’ or ‘low sodium’ packaged foods, these foods also use potassium chloride as a salt substitute. Look on labels for symbols listed as KCl, K+ or potassium and avoid these foods.

7. Be aware of portion sizes when consulting potassium content food lists. When a food is listed as a low sodium food, ask yourself “What serving size is this for?” Don’t eat a pound of something, when it is listed as an ounce.

8. When eating high potassium, leach out the potassium first. Leaching is a technique that removes some of the potassium. For detailed instruction on how to do this, refer to this page:

9. Treat underlying conditions: it is all too easy to get obsessed with reducing potassium from the diet, without looking at the bigger picture… what caused your potassium to rise in the first place? You have high potassium levels because your kidneys are not functioning properly, therefore it is wise to treat your kidneys first.

10. Exercise regularly: exercising regularly helps reduce excess potassium levels in the blood. The mechanism is that through the act of sweating potassium is lost through the skin. Exercise a minimum of 3 times a week, at 30 minutes each time. Build up a sweat, and shed that potassium.

11. Completely avoid dairy: not only is dairy high in potassium, but it is also harmful to your kidneys. That includes dairy from milk, cheese, yoghurt, cream, ice-cream, spreads, dressings, etc. Note: it is also high in phosphorus – another problematic mineral for a lot of kidney disease patients.

In more serious cases however, you will need to employ the helping hand of natural therapies to bring your potassium levels down.

Natural Remedies To Lower Potassium Levels

1. Magnesium: magnesium works by balancing the potassium levels in the blood.
2. Garlic: reduces the absorption of potassium via the digestive tract.
3. Calcium: reduces the absorption of potassium via the digestive tract. Caution: Do not use if you have high calcium levels, get tested first.
4. Note: Licorice is an excellent herb to lower potassium levels (maybe the best), but it comes with its own problems. Firstly licorice is contraindicated in kidney disease for periods exceeding 4 weeks, and licorice also has the potential to increase blood pressure. Do not use this herb unless under the guidance of a health professional.


Remember potassium is important for your survival, but like most things, too much can cause problems. The trick is to get your potassium consumption matched up with your blood potassium levels, to still eat a balanced diet, to have regular blood tests, and to monitor, monitor, monitor your potassium intake for the day. Here is a fantastic KidneyDiet app for your iPhone to do just that.

I hope this article answers all your potassium questions, but most importantly dispels a lot of the mis-conceptions around potassium and its relationship to kidney disease.

I would love to hear your comments or questions, so don’t be shy please scroll down and let me hear from you! I would REALLY appreciate it.

Oh and don’t forget, I have put together a Potassium Food Content Chart for you to download, it is there to make your journey a whole lot easier! So please scroll down, follow the instructions on how to download your food chart, and enjoy.

Thank you for taking the time to read my post on high potassium levels!

See you next time.

To your amazing health,

How To Download the Free Potassium Food Content Chart
Step 1. LIKE, Share, Twitter, or Stumble this article. You don’t have to, but I would appreciate it.
Step 2. Right Click the following, and select Save As to download: Click Here to Download Your Free Potassium Food Content Chart


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