Mineral / electrolyte diet - potassium - restricted - 70mmol
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To limit total potassium intake to 70mmol (2730mg) per day.
Characteristics
Limits foods high in potassium (milk, yoghurt, legumes, nuts, and some fruits and vegetables).
Indications
- hyperkalemia
- patients on haemodialysis
- end-stage renal disease
Nutritional adequacy
This diet may not be nutritionally adequate. Nutrients that may require additional supplementation include fibre, folate, magnesium, calcium and zinc.
Precautions
Suggested meal structure (inclusive of all foods and fluids served at each meal)
- Breakfast: <15mmol (585mg)
- Morning tea: <5mmol (195mg)
- Lunch: <20mmol (780mg)
- Afternoon tea: <5mmol (195mg)
- Dinner: <20mmol (780mg)
- Supper: <5mmol (195mg)
In patients requiring an increased energy intake, encourage use of boiled lollies, soft drinks, cordial, jam, honey and margarine.
Paediatrics
Not suitable for use in paediatrics.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | <10mmol (390mg) potassium per serve | - |
| Sauces, gravies | All (tomato sauce <20ml portion control per day) | - |
| Starchy vegetables / pasta / rice | <7mmol (273mg) potassium per serve White rice and pasta Note: To reduce potassium content of vegetables, boil in large volume of water, rather than steaming or roasting serve | ≥7mmol (273mg) potassium per serve, e.g. baked potato with skin and potato chips Wholemeal, wholegrain or brown rice or pasta |
| Vegetables | <5mmol (195mg) potassium per serve Limit to four serves per day Note: To reduce potassium content of vegetables, boil in large volume of water, rather than steaming or roasting | ≥5mmol (195mg) potassium per serve Mixed legumes, e.g. three-bean mix served as a stand-alone vegetable |
| Soups | Soups with <2.5mmol (100mg) potassium per serve e.g. plain chicken or meat soups with or without noodles or rice | Soups with >2.5mmol (100mg) potassium per serve e.g. tomato, vegetable, pea and ham, minestrone |
| Sandwiches | All | - |
| Salads, dressings | <15mmol (585mg) potassium for full salad <5mmol (195mg) potassium for side salad | >15mmol (585mg) potassium for full salad >5mmol (195mg) potassium for side salad |
| Breads, cereals | All bread and muffins Breakfast cereals with <8mmol (312mg) potassium per serve (e.g. oats, Weet-Bix™, Corn Flakes®, Rice Bubbles®) | Some high bran breakfast cereals or those with added fruit if >8mmol (312mg) per serve |
| Spreads | Butter, margarine, jam, honey | Peanut butter, Vegemite™ |
| Hot breakfast choices | All others | Baked beans, mushrooms |
| Fruit | Limit to 2 serves per day with <5mmol (195mg) potassium per serve Some fresh fruits (e.g. watermelon, mandarin) and all canned fruits (drained if in natural juice) | ≥5mmol (195mg) potassium per serve (e.g. apricots, bananas) Dried fruits |
| Yoghurt | 100g plain or vanilla yoghurt per day | All other yoghurts |
| Desserts | <5mmol (195mg) potassium per serve (e.g. plain cake, pavlova, ice-cream, jelly, apple sponge, creamy rice) At least one choice with <2.5mmol (97mg) potassium per serve must be offered per day | ≥5mmol (195mg) potassium per serve (e.g. fruit cake) |
| Milk and cheese | 150ml milk per day for cereal, tea, coffee or as a beverage (e.g. cow, goat or dairy alternatives) Cheese | Other milk drinks |
| Beverages | Tea, cordial, soft drinks 150ml milk per day for cereal, tea, coffee or as a beverage (e.g. cow, goat or dairy alternatives) Limit coffee to three cups per day | Other milk drinks Fruit and vegetable juices Milo®, cocoa |
| Biscuits | Plain crackers and biscuits (e.g. Sao™, Milk Arrowroot™, Morning Coffee™) | >1.5mmol (58mg) per serve of two biscuits (e.g. some chocolate, wholemeal or fruit biscuits) |
| Miscellaneous | Herbs, spices, vinegar Chutney and pickles (small amounts only) Salt, pepper, sugar, cream | Nuts Chocolate, coconut Salt reduced products with added potassium. Salt replacements |
References
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 17 March 2010].
- National Kidney Foundation. Potassium and your CKD diet. [accessed 13 Aug 2015];
- Voss D. Potassium in pre-dialysis patients. Nephrology 2005;10 Suppl 5:S188-190.