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, gravies | All others | Tomato 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 |
| Soups | None | 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 |
| Spreads | Butter, margarine, jam, honey | Peanut butter, yeast spread |
| Hot breakfast choices | All others | Baked 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
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- National Kidney Foundation. Potassium and your CKD diet.
- Voss D. Potassium in pre-dialysis patients. Nephrology 2005;10 Suppl 5:S188-190.
- 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.