You may have noticed that spring has sprung here in Las Vegas. The trees are blossoming, the pollen is flying in the wind, and there is an abundance of fruits and vegetables in season at the grocery store. This is usually thought of by dietitians and other health minded individuals as one of the best things ever. However, dialysis patients can get into trouble with the bounty of potassium rich foods available. Sadly, in this case, there can be too much of a good thing.
What is potassium? Why do dialysis patients need to watch their intake of it? Where do you find it? Potassium is a mineral found in many foods, but primarily fruits, vegetables, dairy products, beans, grains, chocolate and nuts. It controls nerve and muscle function, and helps maintain fluid and electrolyte balance and PH level. If your blood potassium level is too high or too low, it can cause weakness in any muscle in your body, even your heart, nausea and vomiting, abdominal pain, difficulty breathing, and chest pain and heart attack. Dialysis patients should aim for potassium levels between 3.5-5.5mg/dl.
In order to keep potassium levels in the right range, dialysis patients should limit foods that are high in potassium. Common high potassium foods include cantaloupe, honeydew, avocados, mangos, kiwi, potatoes, tomato sauce, dried fruit, oranges, beets, greens, beans, lentils, and winter squash. ( Ask me for a more comprehensive list.) Eat a variety of foods but in moderation. Remember that even a low potassium food, like berries, applesauce or rice, can become a high potassium food if you eat a lot of it. Keep your portions in check! Don’t drink or use the liquid from canned fruits and vegetables, or the juices from cooked meat. Watch out for Potassium Chloride being used as a salt substitute in low sodium foods like canned soup. Read the ingredient list to find it.
There is a way to reduce the potassium in tuberous vegetables, like potatoes, yams, and yucca. This does not eliminate the potassium in a vegetable, but it decreases it by about 1/3, so portion control still applies. First, wash and peel the vegetable. Slice it thinly or cube into small cubes. You want to have a lot of surface area in touch with the water so the potassium can leach out. Then put the vegetable in a pot and cover with two times as much room temperature water as vegetable. Bring the water to a boil. Drain off the water and add fresh, room temperature water (again twice as much water as vegetable). Bring the water to a boil again and cook until the vegetable is tender.
Sometimes dialysis patients eat a low potassium diet and they still struggle with high potassium levels. There are non-dietary reasons for this at times. They include chronic constipation, insulin-deficiency in diabetics, inadequate dialysis, inefficiency of access, increased activity or exercise, medications like ACE inhibitors and ARBs (angiotensin receptor blockers) commonly prescribed for blood pressure control, GI bleeding, use of chewing tobacco, use of illicit drugs, to name a few. Talk to your doctor or dietitian if you think this may apply to you.
For more help eating the right amount of potassium for your body and getting all the nutrients you need through a rainbow of foods, ask for my help.