High Potassium in Chronic Kidney Disease

May
02

High Potassium in Chronic Kidney Disease

Today is National High Potassium Awareness Day! The American Association of Kidney Patients has celebrated this day for the past three years and the date is anything but random! May 1st is representative of the blood potassium level of 5.1 mEg/L to be under to be considered within a safe range.

What is Potassium?

Potassium is a required mineral needed to regulate water balance, maintain a healthy pH level in the blood, and keep your heart pumping by creating electrical impulses (1). 

The recommended amount of potassium for those with Chronic Kidney Disease (CKD) should be individualized by a doctor based on lab values. The goal is to have blood levels stay within the 3.5-5.0mEq/L range (2).

The Importance of High Potassium in Chronic Kidney Disease

With CKD, the body has a harder time filtering out certain compounds. The power to filter out excess waste and toxins declines as CKD progresses in stage. As a result, potassium levels build up in the body and result in hyperkalemia; another term for high potassium.

Although potassium is hardly anything to call “waste” considering all of the essential functions it helps with, it’s still possible to have too much of a good thing! 

Image of high potassium foods such as mango, guva, figs, and persimmons.

Signs & Symptoms of High Potassium

Early signs and symptoms of hyperkalemia (muscle weakness, nausea, etc.) are often overlooked and hard to attribute to a specific cause without lab tests. Severe cases of hyperkalemia can cause muscle weakness, irregular heartbeat, paresthesias (burning/prickling sensation of the extremities), and cardiac arrhythmias (3). This is why it’s crucial to check your potassium regularly to see if your potassium is trending up so you can make the necessary changes before any signs or symptoms set in at all!

Increased Risk

Having high potassium in chronic kidney disease is common, with one study citing more than 1 in 4 newly diagnosed CKD patients developing hyperkalemia (4). The highest rates of hyperkalemia have been found in those diagnosed with CKD stages 3a, 3b, 4, or 5. Forty-two percent of patients in these stages developed hyperkalemia within the first year of diagnosis (4). 

Furthermore, three other studies found that “potassium levels >5.0 or >5.5mmol/L predicted short-term mortality and cardiovascular events among CKD patients” (4). This highlights the incredible impact that understanding your potassium levels with CKD can have. 

How to Lower Potassium Levels in CKD

There are several approaches to lowering your potassium levels with CKD. Medications, supplements, dietary changes, and even the type of dialysis you receive can affect your potassium levels. 

Low-Potassium Diet

Restricting dietary potassium is a popular method to keep potassium levels under control in CKD. However, many people mistake this to mean that they can’t have any potassium- which is simply not true!

First of all, you should only limit your potassium intake if your doctor or renal dietitian has told you so. If you begin restricting potassium while your kidneys are still functioning at a certain rate, then you could be endangering yourself of low potassium levels (otherwise known as hypokalemia). Research has also shown that unnecessary restriction of potassium may deprive patients of the beneficial effects of a potassium-rich diet (5). 

Secondly, if restriction is needed, know that your recommendation is individualized. Even someone in the same stage of CKD or with a similar GFR can have different potassium limits than you.

Tracking potassium intake can be difficult at first, especially when there are no nutrition facts labels to read on fresh produce, meats, or poultry! Here is a quick-reference list of some foods with high and low potassium levels. Serving sizes are 1 cup unless otherwise indicated. 

Infographic comparing high and low potassium foods per serving.

Source: USDA FoodData Central

When buying pre-packaged foods, always check the nutrition label and ingredients list for potassium amounts. Potassium is sometimes listed at the bottom of the nutrition label, next to iron and Vitamin C. 

Potassium sorbate is a common food additive that is used as a preservative. Look for this near the end of the ingredients list and try to choose products without. 

Potassium-lowering Medications

Oftentimes doctors will prescribe potassium-lowering medications in an effort to control high potassium in chronic kidney disease. Common medications include diuretics or “water pills”. These help to lower potassium levels by removing excess water from the body. These can often be prescribed to help lower blood pressure as well.

Another newer option that is still undergoing research is the potential of potassium binders. The idea behind these is similar to that of phosphate binders, which are very commonly used in CKD patients. However, it remains unclear at this time whether potassium binders are strong enough to prevent hyperkalemia caused by excess consumption through food (6). 

Peritoneal vs Hemodialysis

Potassium is one of the many compounds that is removed during dialysis. Even though both can be great treatment options, research has shown that hemodialysis removes up to twice as much when compared to peritoneal dialysis (7).

Next Steps

Help raise awareness of high potassium in chronic kidney disease! 

Join in on other activities with the AAKP, like their cooking Q&A videos or save the image below to use as your social media profile picture!

Image promoting National High Potassium Awareness Day in green letters.

You can also download and print other AAKP resources pictured below.

Infographic regarding potassium from AAKP website. Click to download PDF file about potassium

Click here to download PDF version

Potassium food label - information on potassium and how to read a food label. Click to donwload PDF file

Click here to download PDF version

Remember that potassium is a mineral that our body needs and those with CKD might need to monitor their intake. Be careful not to unnecessarily restrict your intake as this can also have a negative effect!! Work closely with your doctor and renal dietitian to make sure you are following a plan that is suitable for you! 

How are you taking control of your potassium? Are you keeping track of your numbers? What surprised you the most about potassium in this post? What else would you like to know? Comment below and feel free to ask questions! 


Sources

  1. https://link.springer.com/chapter/10.1007/978-1-4615-1061-1_18 potassium role in body
  2. https://aakp.org/programs-and-events/national-high-potassium-awareness-day-2022-may/ potassium healthy range
  3. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/ factsheet
  4. https://academic.oup.com/ndt/article/33/9/1610/4644812?login=true  1 in 4 CKD HK
  5. https://www.sciencedirect.com/science/article/pii/S0085253819310129 potassium rich diet
  6. https://cjasn.asnjournals.org/content/17/3/467.abstract?casa_token=eef1w3PcUZQAAAAA%3AYXf-nEqcnhTw-DofCScyabfxnNv2t0sWU8JTOwUoI7Eg4LM4LeG14DppE83U_2UC27KAe_nf6rGCgw potassium binders
  7. https://link.springer.com/article/10.1007/s11255-004-6194-y HD vs PD potassium removal

TAGS:

SHARE THIS POST

Leave a Reply

Your email address will not be published. Required fields are marked *

Meet Edith

Registered Dietitian with over 10 years of experience sharing nutrition knowledge that you can use to enjoy food again

The Shop

RESOURCES TO HELP YOU BETTER YOUR HEALTH

FIND ME ELSEWHERE

Grab Your Guide

Complete the form below for instant access