Helping you live a better life on dialysis

Print Page


Potassium helps your nerves “talk” to your muscles, including your heart. Too much or too little potassium can make your heart skip beats - or even stop!

For patients with kidney disease, your monthly lab tests will check your potassium levels to be sure they stay in the safe range. Track your lab results and work with your dietitian to learn how to adjust your food choices, if you need to. Use our Recipe Center to add some variety to your diet. Your potassium level should be less than 6.0 mEq/L for your monthly blood tests.

If your labs are good, then you know you are doing okay. If your potassium is high, write down what you are eating for a week, so you can sit down with your dietitian and figure out how you can do better.

Dialysis And Potassium

The best way you can check your potassium intake while receiving dialysis is to:

  • Ask your dietitian at each monthly lab test what your level is.
  • Choose low- to moderate-potassium fruits and vegetables.
  • In general, choose low and moderate options, and limit high potassium vegetables and fruits to small amounts.

As someone on dialysis, you are likely to have a daily potassium limit. People on peritoneal dialysis (PD) may have between 3,000 and 4,000 mg/day (on PD you do daily exchanges and may even need to eat more foods with potassium).

People on hemodialysis (HD) may have between 2,000 and 3,000 mg/day. Ask your dietitian and your doctor how much potassium you can have each day.

Potassium comes mainly from fruits and vegetables. It is also found in nuts, dried beans, dairy products, and meats. Your body uses what it needs and healthy kidneys remove the rest. Since your kidneys are not working well, extra potassium can build up in your body.

Finding The Nutritional Information You Need

Food labels can give you a lot of information about what is in your food. The law requires packaged foods to have labels that tell you about calories, fat, sodium, carbohydrates, protein, and certain nutrients like vitamin A, vitamin C, calcium, and iron. But food labels do not have to tell you how much potassium is in a food. Some do, but you may need another source for this.

Where can you find out how much potassium is in a food? And how much sodium? And calories? And phosphorus? There are three ways for you to learn, and which one you choose will depend on how much you want to know - and how much work you are willing to do to learn it.

  • Get a list of common foods with high levels of phosphorus, potassium, or sodium. You can ask your dietitian for this. If the foods on these lists are the ones you like to eat, this may be all the help you need to stay healthy.
  • Use a reference book of food values to look up exact values of favorite foods that are not on the lists. This way, you can make good choices and fit in foods you love in safe amounts. Since you do not need the book very often, you can borrow it from a library. You may find that a slice or two of pizza is a treat you can fit into your meal plan.
  • Design your own plan by looking up foods in a food value book and making a daily chart.

Some patients like to do this because it helps them feel more in control - and lets them eat foods that are not on the lists. Looking up foods takes a lot of time at first, but you will start to learn which foods to enjoy in small amounts and which ones you can safely eat more of.

Check Serving Sizes

Have you ever seen a snack-sized bag of chips that only has 110 calories per serving, but there are 3 servings in the bag? Eating three servings can turn even a low potassium food into a high potassium mistake!

Serving sizes work the other way, too. If a favorite food is very high in potassium, you may still be able to enjoy it - in a smaller serving. When you learn about how much potassium fruits and vegetables have, you may want to try out some new foods—and make some new favorites.

Do not think of any food as “off limits.” Pizza with cheese is not off limits. It just means you may have smaller amounts and you will need to calculate your potassium intake for the rest of the day according to your daily allotment. It is not “cheating”- it is being aware of your limits and knowing how much you can afford safely.

Watching what you eat is not the only factor in good potassium control - you also need good dialysis. If your Kt/V or URR (measures of dialysis adequacy) are not in the target range, extra potassium may build up in your body.

Starfruit Is Hazardous To People On Dialysis

Starfruit, also called carambola, looks pretty sliced in a fruit salad. But if you are on dialysis, research shows that starfruit contains a nerve toxin that can cause agitation, confusion, and even death. So enjoy low and moderate potassium fruit - but avoid starfruit!

Fresh Meats May Have Added Potassium And Phosphorus

Watch out! Some fresh meats have been “enhanced” by injecting them with fluid that may have potassium or phosphorus. Meat processors do not have to tell you what they have added - but they do have to tell you if something has been added. Read the label.


Content from Kidney School, a program of the Medical Education Institute, Inc.