Fact sheetDiet specifications

Published on 1 Oct 2016


Mineral / electrolyte diet - potassium - very low - 50mmol

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 50mmol (1950mg) per day.

Characteristics

Limits foods high in potassium (milk, meats, and most fruit and vegetable products).

Indications

When potassium is raised or as medically indicated. Dietary potassium is restricted for patients on dialysis or those with advanced kidney disease, acute kidney injury, and diseases affecting the adrenal glands, such as Addison’s disease. The daily potassium prescription will be determined by the dietitian based on individual patient needs.

Nutritional adequacy

This diet may not be nutritionally adequate. Nutrients that may require additional supplementation include fibre, folate, magnesium, calcium and zinc. An appropriate multivitamin/mineral supplement may need to be given.

Precautions

Requires supervision by a dietitian.

Suggested meal structure

  • Breakfast: <10mmol (390mg)
  • Morning tea: <5mmol (195mg)
  • Lunch: <15mmol (585mg)
  • Afternoon tea: <5mmol (195mg)
  • Dinner: <15mmol (585mg)
  • Supper: <5mmol (195mg)

Encourage use of suitable fats and high joule, low electrolyte drinks, spreads, toppings and sweets or supplement drinks where indicated.

Paediatrics

Not suitable for use in paediatrics.

Specific menu planning guidelines

Allowed Not allowed
Hot main dishes

<10mmol (390mg) potassium per serve

Bacon, sausages, pies, pastries

Beans and lentils

Sauces, graviesAll othersTomato sauce, soy sauce
Starchy vegetables / pasta / rice

All with <7mmol (273mg) potassium per serve including starch alternatives such as cous cous and rice noodles.

1 serve starchy vegetables per day

Note: To reduce potassium content of starchy vegetables, boil in large volume of water, rather than steaming or roasting

≥ 7mmol (273mg) potassium per serve, e.g. baked potato with skin and potato chips

Vegetables

<5mmol (195mg) potassium per serve

Limit to 1 standard serve or 2 x 1/2 serves per meal

Note: To reduce potassium content, boil in large volume of water, rather than steaming or roasting

≥5mmol (195mg) potassium per serve

Any vegetables served with cheese or white sauce

Mixed legumes, e.g. three-bean mix

SoupsNone

All

Sandwiches<10mmol (390mg) potassium per serve and using white bread.Sandwiches with >10mmol (390mg) potassium per serve
Salads, dressings

<10mmol (390mg) potassium for full salad

<5mmol (195mg) potassium for side salad

>10mmol (390mg) potassium for full salad

>5mmol (195mg) potassium for side salad

Breads, cereals

White bread and muffins

Most plain breakfast cereals (e.g. oats, wheat biscuits, puffed rice etc.)

Wholemeal breads and cereals

Bran cereals

Breads and cereals with added fruit, nuts or seeds

SpreadsButter, margarine, jam, honeyPeanut butter, yeast spread
Hot breakfast choicesAll othersBaked beans, mushrooms, tomatoes
Fruit

<5mmol (195mg) potassium per serve, drained (e.g. apples, berry fruits, grapes, peaches, pears, pineapple)

Limit to 2 serves per day

≥ 5mmol (195mg) potassium per serve (e.g. apricots, bananas, rhubarb, oranges)

Dried fruits

Yoghurt-All yoghurts unless prescribed by Dietitian
Desserts<2.5mmol (97mg) potassium per serve (e.g. plain cake, pavlova, ice-cream, jelly, apple sponge, creamy rice)

>2.5mmol (97mg) potassium per serve (e.g. fruit cake, custard, crème caramel)

Milk and cheese

150ml milk per day for cereal, tea, coffee or as a beverage (e.g. cow, goat or dairy alternatives)

All cheeses including cheddar, ricotta and cottage cheese

Milk other than for cereal, tea, coffee

Beverages

Tea, cordial, soft drinks

Limit to 2 cups coffee per day or offer half cups

Milk drinks

Fruit and vegetable juices

Milo®, cocoa

Biscuits

<1.5mmol (58mg) potassium per serve of two biscuits

Low salt crackers or plain sweet biscuits

>1.5mmol (58mg) per serve of two biscuits (e.g. many chocolate, wholemeal or fruit biscuits)

Miscellaneous

Herbs, spices, vinegar, pepper

Sugar, artificial sweetener

Chutney and pickles (small amounts only)

Nuts and seeds

Monosodium glutamate (MSG)

Salt substitutes

References

  1. Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
  2. National Kidney Foundation. Potassium and your CKD diet.
  3. Voss D. Potassium in pre-dialysis patients. Nephrology 2005;10 Suppl 5:S188-190.
  4. Dietitians Association of Australia: Australia and New Zealand Renal Guidelines Taskforce. Evidence based practice guidelines for the nutritional management of chronic kidney disease. Nutr Diet 2006;63 Suppl 2:S35-45.
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