If you have chronic kidney disease (CKD), your potassium levels are being checked and monitored by your doctor. Moreover, your doctor may have recommended you to follow a low-potassium diet. This type of diet can be challenging as it goes against the conventional heart-healthy diet and discourages the overconsumption of certain fruits and vegetables. 

The American Kidney Fund (AKF), in partnership with biopharmaceutical company AstraZeneca, helps to educate CKD patients about potassium through their Beyond Bananas health campaign.* On the Beyond Bananas website, you can learn more about potassium, the consequences of high potassium and what foods fall into that category, and how to manage and track your potassium intake. 

What is potassium?

Commonly found in fruits and vegetables, potassium is both a mineral and an electrolyte, and it plays an important role in the body. Potassium allows your heart (and other muscles) to expand and contract, so it can directly affect your heartbeat. If your potassium levels get too high or too low, it can cause serious, and dangerous, health issues if not treated properly.

How does kidney disease cause high potassium?

If you have CKD, you’re at a higher risk of having high potassium levels because your kidneys cannot remove extra potassium from the body. People who don’t have CKD are able to get rid of extra potassium through urination, but people with CKD will end up with a potassium build-up in their bloodstream. 

Common causes of high potassium in CKD include:

• Eating high-potassium foods
• Using a salt substitute that contains potassium
• Constipation
• Missing dialysis treatments
• Certain medicines, vitamins, and herbal supplements

How do I know if I have high potassium?

For many people, high potassium levels won’t cause any symptoms. For those who do experience symptoms, they typically include one or more of the following:

• Muscle cramps
• Nausea
• Lethargy
• Difficulty breathing
• Irregular heartbeats
• Heart attack 

Since symptoms either do not arise or tend to be very severe, your doctor will want to check your blood potassium levels regularly. Keep in mind, however, that this blood test only allows your doctor to see what your potassium level was at the time you got your blood drawn. Therefore, it is important to ensure you manage your potassium intake closely by following a low-potassium diet. 

How can I manage and treat high potassium?

Dietary changes are the most common way to treat high potassium. Your doctor can refer you to a registered dietitian who will explain what a low-potassium diet entails and tailor it to your unique situation. Certain insurances cover nutrition counseling for CKD, so be sure to reach out to your insurance company before meeting with a dietitian. On the AKF website, you’ll also find a potassium tracker to help you determine the amount of potassium in your food.

Besides diet, high potassium may be controlled with potassium binders. Potassium binders are a type of medication that sticks to potassium during digestion and prevents some of it from being taken into your bloodstream. Most potassium binders come in a tasteless powder form, which you can easily mix with water.

What foods are high in potassium?

Any food with over 250 milligrams (mg) of potassium per serving is considered high in potassium. Most CKD patients are encouraged to limit daily potassium intake to 2500 mg.

Here are some foods with high potassium content: 

• Potatoes (can be double-boiled to reduce potassium content)
• Dried beans
• Oranges and orange juice
• Bananas
• Dairy products, such as milk, cheese, and ice cream
• Tomatoes, including foods prepared with tomato sauce or paste
• Most meats and fish

*American Kidney Fund. (2020, Dec. 5). Beyond Bananas: Potassium and Your Kidneys. https://kitchen.kidneyfund.org/general-nutrients/potassium/