Kidney Patients: The Risks of Low-Sodium Salt and Soy Sauce

Potassium is a mineral that plays an important role in maintaining normal body functions, such as nerve and muscle activity, fluid balance, and blood pressure. However, for people with kidney disease, potassium levels can become too high or too low, causing serious health problems.

In this article, you will learn about:

Table of Contents

Both High and Low Blood Potassium Levels Can Cause Issues

Potassium is a vital mineral that plays many important roles in the body. It helps to regulate fluid and electrolyte balance, transmit nerve impulses, and support muscle and heart functions. Most of the potassium in the body is in the form of ions, which means they have an electric charge. The concentration of potassium ions in the blood affects the activity of the sodium-potassium pump, a mechanism that moves sodium and potassium across cell membranes. The kidneys are mainly responsible for removing excess potassium from the body through urine (about 90%) and feces (about 10%).

The normal range for blood potassium level is between 3.5 to 5.1 mmol/L. When the blood potassium level is too high or too low, it can cause serious health problems. High blood potassium level, also known as hyperkalemia, can interfere with the electrical signals of the heart, causing abnormal heart rhythms, weak heart contractions, and even cardiac arrest. Low blood potassium level, also known as hypokalemia, can also affect the heart rhythm and the strength of the heart muscle. Additionally, low blood potassium level can cause muscle weakness, cramps, fatigue, and constipation.

Some people need to be careful about their potassium intake, especially those with kidney disease or those who receive dialysis. Dialysis is a treatment that filters the blood and removes waste and excess fluid from the body. However, dialysis cannot remove all the potassium from the blood, so people who undergo dialysis need to limit their consumption of high-potassium foods. Other people who need to watch their potassium intake include those with reduced kidney function, those who use peritoneal dialysis (a type of dialysis that uses the lining of the abdomen as a filter), and those who take certain blood pressure medications that can increase potassium levels.

Potassium Content Varies Among Similar Foods

When following a low-potassium diet, it is important to know the potassium content of different foods, especially whole grains, vegetables, and fruits. These foods are rich in various nutrients, but they also contain varying amounts of potassium that can affect your blood levels.

The table below shows some examples of high-potassium and low-potassium foods in each category. Note that the potassium content may vary depending on the variety, origin, processing, and cooking method of the food. Therefore, it is advisable to check the nutrition facts label or consult a dietitian for more accurate information.

Food Category High-Potassium Foods Low-Potassium Foods
Whole Grains Tubers (potatoes, taro, yams, pumpkins, lotus roots), legumes (red beans, green beans, soybeans, peas), brown rice, oatmeal, quinoa, buckwheat, millet White rice, white noodles, white bread, corn, rice cakes, crackers, popcorn
Vegetables Dried vegetables, mushrooms, dark green vegetables (spinach, kale, broccoli, Brussels sprouts), bamboo shoots, tomatoes, beets, winter squash, avocado Light-colored vegetables (cabbage, cauliflower, celery, cucumber, lettuce, radish, zucchini), melons (watermelon, honeydew, cantaloupe), fresh algae (nori, wakame, kelp)
Fruits Dried fruits (raisins, prunes, apricots, dates, figs), most melons, guava, cherry tomatoes, bananas, peaches, star fruit, strawberries, kiwi, oranges, grapefruit, nectarines Apples, grapes, pineapples, tangerines, wax apples, mangoes, cherries, fresh red dates, black dates, pears, blueberries, cranberries, lemons, limes

As you can see, there are many low-potassium foods that you can enjoy in moderation. However, you should also be careful not to overeat them, as too much of any food can increase your potassium intake. 

How to Reduce Potassium Intake in Daily Diet

For kidney disease patients, reducing potassium intake is essential to prevent complications such as irregular heartbeat, muscle weakness, and even cardiac arrest. However, simply avoiding high-potassium foods may not be enough, as potassium can also be affected by cooking methods and seasonings. Here are some tips on how to lower potassium intake in daily diet:

  • Use proper cooking techniques: Soaking high-potassium ingredients in water for 1-2 hours, slicing or cutting them into thin slices or small pieces before cooking, or blanching them in an adequate amount of water for 3-5 minutes can all help decrease potassium content in food. These methods can leach out some of the potassium from the food into the water, which should be discarded afterwards. However, these methods may also reduce the flavor and nutrients of the food, so it is advisable to use fresh and high-quality ingredients and add herbs and spices for seasoning.
  • Avoid potassium-based salt substitutes: Commonly available low-sodium salt, low-sodium soy sauce, delicious and healthy salt, and low-salt soy sauce should be avoided, as they replace some sodium with potassium. These products may seem appealing for people who need to limit their sodium intake, but they can actually increase the risk of hyperkalemia (high blood potassium levels) in kidney disease patients. Instead, it is better to use natural or artificial flavor enhancers such as vinegar, lemon juice, garlic, ginger, onion, etc. to add taste to the food.
  • Limit concentrated soups, broths, and juices: It is also crucial to refrain from consuming concentrated soups, broths, and vegetable or fruit juices, as they can contain a large amount of potassium. For example, one cup of tomato juice can provide about 500 mg of potassium, which is more than 10% of the recommended daily intake for kidney disease patients. Instead, it is preferable to drink water, tea, coffee, or diluted juices, and to make soups and broths with low-potassium vegetables and lean meats.

Tips for Choosing and Preparing Low-Potassium Foods

When you have kidney disease, your kidneys may not be able to filter out excess potassium from your blood. This can cause serious problems, such as irregular heartbeat, muscle weakness, or even cardiac arrest. Therefore, it is important to limit your potassium intake and choose foods that are low in potassium. Here are some tips to help you choose and prepare low-potassium foods:

  • Read food labels carefully. Look for the amount of potassium per serving and the % Daily Value (DV). Foods that have less than 200 mg of potassium and less than 5% DV are considered low in potassium. Foods that have more than 300 mg of potassium and more than 10% DV are considered high in potassium. Avoid foods that have potassium chloride, potassium citrate, or potassium phosphate as ingredients, as they are sources of added potassium.
  • Choose fresh or frozen fruits and vegetables over canned or dried ones. Canned and dried fruits and vegetables tend to have more potassium than fresh or frozen ones. If you do use canned fruits and vegetables, rinse them well with water before eating or cooking to remove some of the potassium. You can also soak high-potassium vegetables, such as potatoes, sweet potatoes, and squash, in water for at least two hours before cooking to leach out some of the potassium.
  • Cook foods in water and drain the water before eating. Boiling, steaming, or roasting foods in water can help reduce their potassium content, as some of the potassium will leach into the water. However, do not reuse the water for soups, sauces, or gravies, as it will contain the potassium that was removed from the foods. Instead, discard the water or use it to water your plants.
  • Limit your portion sizes. Even low-potassium foods can become high-potassium foods if you eat too much of them. For example, one small apple has about 150 mg of potassium, which is low, but four small apples have about 600 mg of potassium, which is high. Follow the serving sizes recommended by your dietitian or doctor, and use measuring cups and spoons to control your portions.
  • Use herbs, spices, vinegar, lemon juice, or other low-sodium seasonings to flavor your foods. Avoid salt substitutes, low-sodium salt, low-sodium soy sauce, and other products that contain potassium chloride, as they can increase your potassium intake. Also, avoid using garlic salt, onion salt, celery salt, and other salt-based seasonings, as they can increase your sodium intake. Instead, use garlic powder, onion powder, celery seed, and other salt-free seasonings.

Frequently Asked Questions

What are the symptoms of high or low blood potassium levels?

Potassium is a vital mineral that helps regulate fluid and electrolyte balance, nerve transmission, and muscle and heart contractions. Most of the potassium in the body is found inside the cells, and only a small amount is present in the blood. The normal range for blood potassium concentration is between 3.5 to 5.1 mmol/L. When the blood potassium level is too high or too low, it can affect the function of the cells and organs, especially the heart.

High blood potassium levels, also known as hyperkalemia, can occur due to kidney disease, diabetes, dehydration, tissue injury, or certain medications. Hyperkalemia can cause symptoms such as:

  • Muscle weakness, numbness, or tingling
  • Nausea, vomiting, or diarrhea
  • Slow or irregular heartbeat
  • Chest pain or shortness of breath
  • Confusion or drowsiness

Low blood potassium levels, also known as hypokalemia, can occur due to excessive fluid loss, malnutrition, vomiting, diarrhea, or certain medications. Hypokalemia can cause symptoms such as:

  • Muscle cramps, spasms, or pain
  • Fatigue or weakness
  • Constipation or abdominal bloating
  • Fast or irregular heartbeat
  • Fainting or dizziness

Both high and low blood potassium levels can be life-threatening if not treated promptly. Therefore, it is important to monitor your potassium levels and seek medical attention if you notice any of the above symptoms.

Reference

  • National Kidney Foundation. Potassium and Your CKD Diet. 
  • National Kidney Foundation. Potassium Tracker. 

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