If you’re living with kidney disease, potassium management is an important part of protecting your overall health. Potassium is a mineral that helps regulate nerve, muscle, and heart function. When the kidneys can’t remove excess potassium efficiently, levels can become dangerously high. Sometimes this happens without any noticeable symptoms.

Many common beverages can be surprisingly high in potassium, making it easy to consume more than intended. Your doctor or registered dietitian nutritionist can help determine how much total daily potassium is healthy for your body and personal needs. This guide to high- and low-potassium drink options can be a perfect tool alongside your kidney disease treatment plan.

Black coffee is a low-potassium beverage at about 124 mg per 1-cup serving.

What Is Potassium?

Potassium is an electrolyte, alongside sodium and calcium, and a mineral that your body must get from foods and drinks. It’s needed in order to help your muscles move, and your heart beat. It also has many health benefits, including:

• Supporting brain function
• Improving bone and tissue health
• Preventing cramps
• Balancing fluids
• Regulating blood sugar and blood pressure

Hyperkalemia

When potassium levels get too high in the body, it’s called hyperkalemia. Because potassium regulates the heart and supports brain function, hyperkalemia can be dangerous and may require emergency care. Some symptoms of hyperkalemia may include heart flutters, numbness or tingling, and muscle weakness.

In general, it’s best to get potassium from food sources rather than supplements, unless your doctor recommends it.

High potassium may develop if you have kidney disease because the kidneys have difficulty getting excess amounts of potassium out of the body. It can also happen if you eat or drink too much potassium, especially with advanced chronic kidney disease. Certain medications, supplements, and other diseases can also cause hyperkalemia.

Hypokalemia

Potassium levels can also get too low and cause problems in the body. Low potassium, also called hypokalemia, may occur during the early stages of kidney disease. Symptoms of hypokalemia may include irregular heartbeat, fatigue, muscle spasms or weakness, and constipation. Since potassium is found in body fluids, frequent diarrhea, vomiting, or sweating can lead to hypokalemia. Certain conditions and medications may also contribute to low levels of potassium.

Potassium Recommendations

For general health, the Academy of Nutrition and Dietetics recommends that men have about 3,400 milligrams (mg) of potassium and women about 2,600 mg per day. If you have kidney disease, it’s important to get specific recommendations from your healthcare team. For example, if you’re on dialysis, a healthy goal may be about 2,500 mg of potassium. Your doctor can do a simple test to check the amount of potassium in your blood and give specific recommendations and treatment steps. In general, it’s best to get potassium from food sources rather than supplements, unless your doctor recommends it.

Symptoms of high potassium may include heart flutters, numbness or tingling, and muscle weakness.

It’s helpful to determine whether a food or drink is high or low in potassium. If a food or drink has more than 200 mg of potassium in each half cup, it’s considered to be high in potassium. Some examples of high-potassium foods include lentils and legumes, cantaloupe, and dried fruits like raisins and apricots. Foods considered lower in potassium contain less than 150 mg per half cup. A few examples of low-potassium food sources include apples, some berries, and eggplant.

High-Potassium Drinks

Fruit Juice

Many fruit juices are high in potassium because they become more concentrated when the fruit is juiced. Orange juice and prune juice are considered to be high-potassium sources. Pomegranate fruit is very high in potassium, with 666 mg of potassium in each fruit. This would be even higher if the seeds are juiced.

Vegetable Juice

Vegetables are an important part of a healthy diet, but some vegetable juices should be limited on a kidney health diet. Some of the highest sources are tomato juice and vegetable juice, such as V8 juice. It’s not just the juice that deserves attention. Tomato sauce and some soups may also be high in potassium. Tomato paste is very high, at 669 mg per ¼-cup serving.

Smoothies

Smoothies or juice blends are tricky because they contain a variety of fruits or vegetables, which may or may not have high potassium levels. They typically combine potassium-rich ingredients like bananas, spinach, and low-fat yogurt. Making your own at home can help you control what goes into the smoothie. You can choose lower-potassium options like pineapple, watermelon, and raspberries.

Protein Shakes

Many protein shakes contain milk or milk products like whey protein, which are a higher source of potassium. Certain shakes are fortified with electrolytes, like potassium, to resemble sports drinks. Some contain potassium additives, which ups the total potassium count. If you’re buying a protein shake at the store, check the nutrition label to see how much potassium it has.

Sports Drinks

Many sports drinks or electrolyte replacement beverages contain added potassium to replace electrolytes lost through sweat. Potassium content varies from brand to brand, so it’s important to check the label for the amount of potassium. Make sure to take note of the portion size because some bottles contain more than one serving.

Coconut Water

Coconut water is often marketed as an all-natural sports drink. The problem is that when consumed in excess, it has been reported to cause hyperkalemia. It’s one of the highest sources of potassium. Just one cup contains about 600 mg of potassium.

Low-Potassium Drinks

Plain and Sparkling Water

Plain water is a great low- to no-potassium choice. Certain water softeners may increase the potassium level, so it may be worth asking your doctor and testing your water. Most unflavored sparkling waters are also potassium-free, unless they have minerals or electrolytes added. Always check the label and avoid the ones that say “mineral” water or “enhanced.”

Black Coffee

Black coffee is a low-potassium beverage at about 124 mg per 1-cup serving. Milk and plant-based milks contain potassium, so it’s important to consider any coffee additions. For example, ½ cup of whole milk contains 184 mg of potassium. The same goes for something like a mocha. Cocoa mix is considered to be a medium source of potassium at about 204 mg per 6 fluid ounces.

Unsweetened Tea

Unsweetened teas, without added sugar, are typically low in potassium. Just make sure you’re using water without added minerals or electrolytes. There are many tea options to choose from, such as black, green, and herbal teas. But consider the potassium level of any additions like milk, plant milks, or creamers.

Tips for Managing Potassium for Kidney Disease

It’s important to follow the medical advice of your nephrologist and dietitian for a potassium treatment plan because they can consider medicines you’re taking, what you eat, and your medical history. However, your daily food and drink choices can help you manage your potassium levels and stay safe. Here are a few everyday steps you can take to help manage your potassium levels:

• Check the nutrition facts label for total potassium levels and consider a nutrient tracker.
• Scan the ingredient list for potassium additives or salt substitutes like potassium chloride, potassium citrate, and potassium phosphate.
• Consider smaller portions of your favorite drinks or dilute them with water. Swap lower-potassium ingredients in smoothies or coffee.

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Which kidney disease-friendly drinks do you enjoy? Let others know in the comments below.