Potassium Intake in Chronic Kidney Disease (Predialysis and Dialysis)

Potassium is the third most abundant mineral in your body. Potassium is mainly located within the cells and is considered as the ionic counterpart to sodium and chloride. A proper balance between these minerals is necessary for many body functions. Potassium is essential for the proper function of all cells, tissues, and organs – including your heart.

Potassium is involved in:

  • Muscle contraction 
  • Maintaining the electrolyte and fluid balance within the cells 
  • Conduct nerve impulses

Why should you watch your potassium intake if you suffer from CKD?

A proper functioning of all cells, tissues, and organs – including your heart, depends on potassium. Kidneys are responsible for maintaining the optimal potassium level in your blood. In chronic kidney disease, when your kidney function is impaired, potassium levels in your blood can be affected. This may already occur in predialysis.

Additionally to the increased potassium intake with your diet and its reduced elimination, the potassium levels in your blood can be indirectly influenced by your daily energy intake: If not enough energy is given, muscles will be degraded and potassium will be released from the muscles into your blood.

Haemodialysis treatment might not be sufficient enough to remove all excessive potassium. Thus, it may be necessary to reduce your potassium intake between the dialysis sessions.

In peritoneal dialysis, potassium is removed each time an exchange is performed. It can cause low potassium levels making it necessary to increase your intake (diet/supplement). Controlling potassium will require monitoring of your blood levels every month.

High blood potassium levels may cause irregular heart rhythm.

13_CA_Text 504

High potassium levels are dangerous. Symptoms of too much potassium may include weakness, nausea and irregular heartbeat.

Consult your doctor regarding your potassium blood level. High potassium levels are frequently treated with diuretics. Your dietician will help you to choose the right food to control the intake of potassium – if necessary.

What are the main sources of potassium in your diet?

High potassium foods are:

  • Avocado, banana, orange, kiwi, grapes, melon, dried fruits 
  • Fruit juice 
  • Dark green leafy vegetables, broccoli, dried beans, potatoes, tomatoes 
  • Nuts/almonds 
  • Whole grain breads/cereals 
  • Milk and milk products 
  • Condiments – salt substitutes (= exchange of sodium by potassium )

Tips to reduce your daily potassium intake

  • You can remove some potassium from potatoes and other vegetables by peeling and cutting them into small slices and soaking them in water at least for 2 hours. 
  • Cooking reduces potassium content of fruit and vegetable by 50%. 
  • Use canned fruits (without eating the canned fluid). 
  • Use frozen fruits and vegetables. 
  • Cook vegetables and potatoes separately when preparing a hotpot or casserole.

Recommended Intake

Content last updated
  1. Cano N, Fiaccadori E, Tesinsky P et al.: ESPEN Guidelines on Enteral Nutrition: Adult Renal Failure. Clin Nutr 2006; 25: 295–310.
  2. Fouque D, Vennegoor M, ter Wee P et al.: EBPG Guideline on Nutrition. Nephrol Dial Transplant 2007; 22 (Suppl 2): ii45–ii87 http://ndt.oxfordjournals.org/cgi/content/full/22/suppl_2/ii45 (last visited 20.04.2010)