What to Eat for Hyperkalemia (2024)

You'll need to ensure that your low-potassium diet is full of low-potassium options that pack substantial nutrition; you may also be able to include small portions of high-potassium foods in your diet.

Working with a registered dietitian can help you create a low-potassium meal plan that is both effective and nourishing.

Who Should Follow a Low-Potassium Diet?

Certain health conditions and some medications can affect how well yourkidneys regulate potassiumin your body. A low-potassium diet, therefore, may be recommended if you have:

• Chronic kidney disease
• Kidney failure
• Type 1 diabetes
• Addison’s disease

It's also recommended if you take:

• Angiotensin-converting enzyme (ACE) inhibitors
• Renin-angiotensin-aldosterone system (RAAS) inhibitors

Depending on your situation, this may be to treat your high levels or get ahead of the potential risk.

If your provider recommends that you eat this way, it's important that you follow the recommendation—even if you feel fine. It can take months for your potassium to get to a dangerous level. During that time, you may not have any symptoms.

What to Eat (and Avoid) on a Low-Potassium Diet

Most foods contain some potassium. If you’re on a potassium-restricted diet, you’ll need to avoid foods that are high in potassium (generally over 200 mg per serving). You’ll also need to avoid consuming large quantities of any food or drink that contains potassium—even low amounts—as this can also raise potassium levels.

Your healthcare provider and a dietitian can help determine how many servings of low-potassium foods (generally 150 mg or less per serving) you can have each day.

Fruits and vegetables: Fresh produce is generally rich in potassium. When eaten raw, many fruits and veggies are too high in potassium for a low-potassium diet. However, you may be able to have them if you limit portions and/or cook them to reduce the potassium content. Some canned fruits and vegetables can also work as long as you drain and rinse them.

Dairy: Milk products need to be avoided, or at least limited, on a low-potassium diet. You may be able to have a small serving of milk or yogurt each day. Some types of cheese (including cottage cheese) are low enough in potassium that you may be able to include them in your diet.

If you add milk to your tea or coffee, switch to a non-dairy creamer or milk alternative such as rice milk. However, avoid soy milk.

Grains: Instead of whole grains and bran, look for rice cereals or bread made from refined flour. White rice and pasta noodles made from refined white flour are approved on a low-potassium diet. Soda crackers, unbuttered popcorn, and puffed rice are lower-potassium snack options.

Protein: Most animal and plant-based protein are high in potassium. However, you need to include some protein in your diet. Choose lower-potassium options or have smaller portions of high-potassium sources.

Egg whites are one lower-potassium option. You may be able to have small servings of nuts (one small handful) or peanut butter (a single tablespoon).

Avoid sausage, bacon, lunch meats, and any other processed meats with additives that may contain potassium. Whenever you cook meat of any kind, be sure to drain the juices and discard them instead of using them for sauces, basting, or gravy.

Sweets: Many desserts are made with ingredients that are high in potassium, such as nuts, syrups, and chocolate. Be careful when choosing cookies, cakes, and ice cream. Look for plain yellow cakes (such as angel food or sponge cake) with no icing, frosting, toppings, or fillings.

Clear gelatin, honey, and maple syrup are lower-potassium choices. If you’re baking, white sugar is a lower-potassium choice than brown sugar.

Beverages: Dehydration can disrupt the electrolyte balance in your body and lead to hyperkalemia. Water is the best choice for staying hydrated, but other approved beverages on a low-potassium diet include fresh lemonade and juice made from low-potassium fruit or frozen fruit concentrate.

One 8-ounce cup of iced or hot coffee a day is OK. Tea is also acceptable, as long as you stick to 16 ounces per day. It can be served hot or on ice either plain or sweetened with lemon and sugar or honey. Avoid high-potassium herbs such as alfalfa, dandelion, and nettle, which are often used in tea (and seasoning) blends.

Cooking Tips

If you don't want to completely give up your favorite high-potassium produce, learn how to leach vegetables. While this cooking method can make some higher potassium foods safer to eat, talk to your healthcare provider before you add leached vegetables to your diet.

Even if you remove some of the potassium from a vegetable, you’ll still want to only have it on occasion.

Duration

If your potassium levels are high due to a chronic health condition, you may need to make permanent changes to your diet to keep your levels managed.

Depending on the cause of hyperkalemia, your healthcare provider may allow you to add more potassium back into your diet. However, if your potassium levels get high again, you will likely need to resume a potassium-restricted diet until they are under control.

In some cases, following a potassium-restricted diet may not be enough. If your potassium levels don't respond to changes in your diet, you may need to take medication or have dialysis treatments.

Benefits of a Low-Potassium Diet

Some research has shown that certain negative effects of high potassium may respond to a low potassium diet.

For example, a 2017 study published in the Clinical Journal of the American Society of Nephrology found that patients with stage 3 or 4 chronic kidney disease were less likely to experience neuropathy on a potassium-restricted diet.

The benefits of a low-potassium diet for everyone at risk, however, are debated by some. Several research studies have looked at whether potassium-restricted diets are helpful for certain people, such as patients with kidney disease who are on dialysis. A 2016 study cited inconclusive evidence of a strict low-potassium diet’s effectiveness, in part because it’s unclear whether the body considers all dietary sources of potassium (plant and animal) equal.

The study's findings also suggest that potassium-restricted diets may do more harm than good for some patients. However, because there are no other evidence-based dietary treatments for hyperkalemia, most researchers believe healthcare providers should continue to prescribe low-potassium diets.

Considerations

While pretty straightforward, there are some things you need to be aware of when beginning a low-potassium diet.

Safety

If you are following a low-potassium diet, you may choose to take supplements to bridge the gap in terms of the nutrition your diet provides and what your body needs. Taking supplements that contain potassium can thwart your eating efforts, read labels carefully. In fact, it is best to run any supplements you are considering by your healthcare provider first.

Flexibility

It's possible to dine out on a low-potassium diet, but you may need to exercise extra caution when evaluating your options.

Choose low-potassium foods and keep an eye on portions, which are often oversized at restaurants.

Dietary Restrictions

You may have other dietary needs and preferences to consider along with your low-potassium diet. For example, you may need to avoid gluten due to celiac disease, or you may prefer to follow a plant-based diet.

Additional dietary restrictions only enhance the challenge of getting proper nutrition while on a low-sodium diet. Thus, it's best to get professional help to figure out how to meet all your dietary needs.

Additionally, if you have another health condition that can be affected by your diet, such as high blood pressure (hypertension) or diabetes, your healthcare provider may have you make other changes to what you eat and drink.

If you’re overweight or have other risk factors (such as a family history of heart disease) your healthcare provider may suggest you limit your fat intake. High-fat, high-cholesterol foods not only put stress on your kidneys, but they can also contribute to obesity and conditions such as atherosclerosis.

Side Effects

The most common side effect of a low-potassium diet is constipation. If you’re not able to increase your intake of fiber-rich foods to help things along, your healthcare provider may suggest a fiber supplement.

You should also be aware of the signs of an acute spike in your potassium levels, which can be dangerous. More subtle symptoms of hyperkalemia include general fatigue and nausea, but acute hyperkalemia can cause trouble breathing, a racing heart, and chest pain. If you have these symptoms, seek immediate emergency medical care.

Summary

Potassium is an essential mineral the body needs to function properly, but sometimes too much builds up in the blood. Usually, this happens because of a medical condition. Too much potassium could potentially be fatal.

To regulate your levels, avoid high-potassium foods and keep serving sides to recommended amounts. Depending on the cause of hyperkalemia (high potassium), dietary changes may need to be permanent.