From the Guidelines
High potassium foods, such as bananas, oranges, potatoes, and tomato products, should be limited in children with CKD stages 2 to 5 and 5D who have or are at risk of hyperkalemia, as they can exacerbate the condition and lead to serious cardiac complications 1. To manage hyperkalemia, it is essential to restrict dietary potassium intake, and the suggested limit is less than 2,000 to 3,000 mg (50 to 75 mmol/d) of K daily for adults, which is equivalent to less than 30 to 40 mg/kg/d (0.8 to 1 mmol/kg/d) for a 70-kg standard adult 1. For infants and young children, a reasonable starting point may be 40 to 120 mg (1 to 3 mmol/kg/d) of K, considering that breast milk has a relatively low potassium content of 546 mg/L (14 mmol/L) compared to standard commercial cow’s milk-based infant formulas 1. Some high-potassium foods that children should limit or avoid include:
- Bananas
- Oranges
- Potatoes and potato chips
- Tomato products
- Legumes and lentils
- Yogurt
- Chocolate It is crucial to note that the nutrition facts panel on food labels may not always list potassium content, but foods containing less than 100 mg or less than 3% DV are considered low in potassium, while those containing 200 to 250 mg or greater than 6% DV are considered high in potassium 1.
From the Research
High Potassium Foods
There are no research papers provided to assist in answering this question about high potassium foods. The studies available 2, 3, 4, 5, 6 focus on the treatment of hyperkalemia using sodium polystyrene sulfonate, but do not provide information on high potassium foods.
Treatment of Hyperkalemia
- Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia 2, 3, 4, 5, 6
- SPS works by exchanging sodium for potassium in the colon 6
- The efficacy and safety of SPS for the treatment of hyperkalemia have been questioned due to reports of bowel necrosis and other serious gastrointestinal adverse reactions 3, 5, 6
Key Findings
- A study found that low-dose SPS was well-tolerated and effectively normalized elevated serum potassium in patients with mild chronic hyperkalemia 2
- A systematic review found that most studies demonstrated a reduction in serum potassium with SPS use, but the evidence was limited by heterogeneity and lack of high-quality studies 3
- Another study found that the use of a hyperkalemia order set was associated with appropriate use of SPS and improved patient outcomes 4