Hyperkalemia means the level of potassium in your blood is higher than normal. It’s often caused by kidney problems. High potassium can affect your heart and other muscles. It can also become dangerous if symptoms aren’t treated right away.

There’s no single diet that works for everyone with kidney conditions or hyperkalemia. Potassium requirements vary depending on your kidney function, medications, and overall health. That’s why it’s important to talk to your healthcare provider or dietitian before making changes to your diet or taking supplements. Below, learn which low-potassium foods may be safer choices and which high-potassium foods are best to limit or avoid.

What Is Hyperkalemia?

We need potassium for muscle movement, nerve signals, and blood pressure control. Healthy kidneys can filter excess potassium through the urine (pee). But too much potassium can harm the heart and potentially cause serious heart rhythm problems.

High potassium levels can happen when the kidneys can’t remove enough potassium from the blood, when you eat too much potassium, or when certain medications affect how your body regulates potassium. Some examples of medications that affect potassium levels include diuretics, which help your body get rid of extra fluid through urine, and blood pressure medications. Hyperkalemia is also common in people with various kidney diseases or other kidney problems.

Hyperkalemia is typically defined by potassium levels above 5.0 to 5.5 millimoles per liter. Normal levels of potassium are from 3.5 to 5.5 millimoles per liter. When levels go above 6.5 millimoles per liter, emergency medical care is required to prevent heart problems.

Diet for Hyperkalemia

Diet is one of the most important factors in managing the levels of potassium in the blood. Working with your nephrology doctor and kidney dietitian will help determine what your levels should be. They can help you create a daily meal plan that supports normal potassium levels. In addition to working with your healthcare team, you can track your potassium levels by reading the nutrition label. If the food or beverage has a nutrition label, check for these:

• Serving size
• Number of servings per container
• Amount of potassium per serving

This information can help you figure out how much potassium you’re getting in one serving of that food or drink. That way, you can avoid eating more potassium than you planned.

The percentage of potassium per serving is defined as:

• Low — 100 milligrams or less (3 percent)
• Medium — 101 to 200 milligrams (3 percent to 6 percent)
• High — 201 to 300 milligrams (6 percent to 9 percent)
• Very high — Over 300 milligrams (9 percent)

4 Low-Potassium Foods To Eat With Hyperkalemia

A low-potassium food is considered to be less than 200 milligrams of potassium per serving. Portion control can help you regulate the amount of potassium you’re getting. For fruits, vegetables, and other foods that contain potassium, aim for 1/2 cup per serving.

1. Low-Potassium Fruits

Although fruits are part of a healthy diet, some have high amounts of potassium. You can reduce the total amount of potassium you’re getting per day but still make sure you get the benefits of plant-based foods. A good rule of thumb is having two to three servings of low-potassium fruits per day. Berries, like raspberries, cranberries, and blueberries, as well as grapes, are good options. Other low-potassium fruits include pineapple, pears, peaches, and grapefruit.

Raspberries, cranberries, blueberries, and grapes are good low-potassium fruit options.

When it comes to juicing, there may be some benefits, such as hydration. But for someone with limited kidney function, fluids may need to be monitored or decreased. Juiced fruits can contain more potassium per serving. Juices or smoothies with multiple fruits may make it hard to figure out the amount of potassium.

2. Low-Potassium Vegetables

Good go-to choices for low-potassium vegetables are asparagus, iceberg lettuce, celery, and cucumbers. Some root vegetables are great lower-potassium options, including carrots, radishes, onions, and turnips. A good serving size to aim for is 1/2 cup for many vegetables, including those mentioned and others like broccoli, cauliflower, eggplant, and squash.

Same as with fruit, juicing increases the potassium level per serving. Commercial vegetable juices or canned tomato juice can also be high in sodium, which is a concern for some people with reduced kidney function. Juicing vegetables like spinach or kale, which are high in vitamin K, may interfere with some blood-thinning medications. This is why it’s always important to check in with your nephrology doctor and dietitian before juicing.

You can decrease the amount of potassium in vegetables by leaching them before cooking. This process involves peeling vegetables, putting them in cold water, rinsing with warm water, soaking, and cooking them with more water. You can also lower the amount of potassium you get by draining and not using the liquid from canned vegetables and fruits.

3. Refined Grains

Whole grains are typically recommended for a healthy diet because they provide vitamins and minerals and help reduce the risk of heart disease and diabetes. On a low-potassium diet, refined grains like white rice, white pasta, and white bread are often recommended because they have less potassium than whole grains. This makes it even more important to get nutrients like fiber from low-potassium fruits and vegetables.

4. Some Protein Foods

We need protein foods to keep our bodies strong, healthy, and fight off infections. How much you need depends on several factors, especially if you have reduced kidney function. The kidneys filter out waste from protein we eat. Because of this, and because you may need to limit potassium, it’s important to pay attention to portion sizes.

For a low-potassium diet, the recommended serving amount of animal proteins like meat, fish, and poultry is often small, depending on your kidney function and what your care team recommends. Some lower-potassium protein sources may include small portions of nuts and seeds, depending on your potassium limits and what your healthcare provider recommends. Lower-potassium animal protein choices would be chicken, eggs, tuna, and turkey.

3 High-Potassium Foods To Avoid With Hyperkalemia

Taking in more potassium than your body can filter out can lead to serious heart problems. One cause of hyperkalemia is a high-potassium diet. High-potassium foods are considered to be more than 200 milligrams per serving.

1. High-Potassium Fruits

Some fresh fruits are naturally high in potassium, like oranges and nectarines. Some tropical fruits like mango, papaya, and banana are higher in potassium. When fruits are dried, the potassium amount increases. That’s why dried fruits like figs, prunes, and dates are best to limit or avoid when trying to lower your potassium intake. As for juice and smoothies, check the nutrition label on commercial products to monitor the total potassium per serving.

2. High-Potassium Vegetables

As a rule of thumb, aim for about a 1/2-cup serving of vegetables. Common vegetables that are high in potassium include root vegetables like sweet potatoes, pumpkin, and white potatoes. You also want to watch for dark leafy green vegetables like chard or spinach. Tomato and tomato-based products like sauces are a high source of potassium.

3. Dairy

Dairy products, including milk and yogurt, are high in potassium. Dairy products also include ice cream, cottage cheese, cheese, and puddings. If you have reduced kidney function, it’s best to limit dairy to help control your daily intake. Dairy products also contain protein, phosphorus, and calcium. You may need to limit these nutrients to help lower the risk of other health problems linked to kidney disease.

Potassium requirements vary depending on your kidney function, medications, and overall health.

Talk to Your Healthcare Provider

Managing your hyperkalemia should be personal, realistic for your daily life, and guided by your nephrology doctor and dietitian. Following a hyperkalemia-friendly diet focuses on lower-potassium foods while limiting the high-potassium foods to support healthy levels and overall well-being. Before making any changes to your kidney health diet, always consult a healthcare provider, especially if you have kidney disease or other medical conditions or are taking medications that affect potassium.

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Which low-potassium foods do you enjoy for better kidney health? Let others know in the comments below.