Potassium diet - low
This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.
Aim
To provide a potassium-controlled diet to minimise the occurrence and degree of hyperkalemia.
Characteristics
Restrict foods containing more than 390mg potassium (10mmol) per standard serve. Foods that contain moderate amounts of potassium are allowed, but quantity of serves/serving size may be limited. Two serves per day of dairy to meet calcium and protein needs is required. Boost energy intake with sugars, fats and energy supplements as required.
Level of potassium restriction will vary with the age of the child, medical condition and clinical indicators (serum potassium level). Energy intake needs to be maintained to assist in potassium regulation and to meet energy requirements.
Indications
- haemodialysis/peritoneal dialysis
- renal failure
- elevated serum potassium levels.
Nutritional adequacy
This diet should be nutritionally adequate. Nutrients that may need additional supplementation however include: fibre, magnesium, calcium and zinc.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | <10mmol (390mg) potassium per serve Dishes made from fresh/roast or grilled meat Fish, chicken, eggs, tofu, legumes or lentils Use fresh tomato instead of tomato paste | >10mmol (390mg) potassium per serve |
| Sauces, gravies | All when included as part of main meal allowance | - |
| Starchy vegetables/pasta/rice | <7mmol (270mg) potassium per serve Potato, pumpkin and sweet potato: boiled twice, changing the water in between Pasta/rice | >7mmol (270mg) potassium per serve Potato/sweet potato – steamed, baked, jacket, chips Potato crisps Pumpkin, baked |
| Vegetables | <5mmol (195mg) potassium per serve Alfalfa sprouts, asparagus, cabbage, capsicum, cauliflower, carrots, celery, frozen corn, cucumber, eggplant, green beans, lettuce, onion, squash, zucchini – limit 2-3 serves per day, boiled preferable to steamed | >5mmol (195mg) potassium per serve Artichoke, beetroot, broccoli, brussels sprouts, fresh corn, mushrooms, tomato, silverbeet, spinach Canned beans (e.g. kidney, lima, navy) Dried peas (e.g. chickpeas, lentils, split peas) |
| Soups | None | All types |
| Sandwiches | White bread | Wholemeal bread |
| Salads, dressings | <15mmol (585mg) potassium per full salad serve <10mmol (390mg) potassium per side salad serve Dressings – portion control only | All others |
| Breads, cereals | All white bread and muffins Most plain breakfast cereals (e.g. oats, Weet-Bix™, cornflakes, Rice Bubbles®) | Wholegrain and wholemeal Bran cereals, and those with added fruit (e.g. Sultana Bran®, Just Right®, muesli) |
| Spreads | Butter, margarines, jam, honey | Vegemite™, peanut butter |
| Hot breakfast choices | All others – eggs, bacon, sausages, canned spaghetti | Baked beans Hash brown |
| Fruit | Apple, berry fruits, cherries, grapes, kiwi fruit, mango, peaches, pears, pineapple, plums, watermelon Canned fruit in water, drained – two fruits, peaches, pineapple, pear | Apricot, avocado, banana, honeydew, kiwi fruit, mango, melon, orange, rhubarb All dried fruits Canned fruit in juice |
| Yoghurt | Yoghurt as part of 2 dairy serves per day total | - |
| Desserts | <5mmol (195mg) potassium per serve Plain cake, pavlova, jelly, apple sponge, creamy rice Custard, ice-cream and yoghurt as part of 2 dairy serves total | All others |
| Milk and cheese | 2 serves dairy per day include milk, cheese, custard, yoghurt, soy and soy alternatives | Protein enriched milk (e.g. Shape™) |
| Beverages | Cordial, soft drinks, apple juice Milk or milk alternatives as per dairy allowance | Orange, tropical and vegetable juices Milo®, cocoa |
| Biscuits | Plain crackers and biscuits (e.g. Sao™, Milk Arrowroot™, Morning Coffee™) | Chocolate, wholemeal or fruit biscuits |
| Miscellaneous | Rice snacks, corn chips Garlic, herbs, spices, vinegar Chutney and pickles (small amounts only) | Potato crisps Nuts MSG |
References
- Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
- Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
- Dietitians Association of Australia. 2009. Nutrition Manual 8th ed. Canberra: DAA.
- American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
- National Kidney Foundation. Potassium and your CKD diet. NKD: New York.
- Voss, D. Potassium in pre-dialysis patients. Nephrology 2005;10(Suppl 5):S188-S190.
- CARI Guidelines. Potassium in pre-dialysis patients. 2004.
- Heart Foundation Healthy Eating.
- NHMRC 2003 Dietary Guidelines for Children and Adolescents in Australia.
- ANZRGT evidence based practice guidelines for nutrition management of CKD in adults.
- Pennington and Douglas Bowes & Church’s Food Values of Portions Commonly Used, 18th ed. Lippincott Williams & Wilkins; 2005.
- Caring for Australians with Renal Impairment Guidelines.
- National Kidney Foundation Kidney Disease Outcome Quality Initiative.
- Shaw V and Lawson M. 2007. Clinical Paediatric Dietetics. 3rd Edition. Blackwell Publishing.