Chronic kidney disease (CKD) impairs the kidneys’ ability to filter excess potassium, which may lead to high potassium levels in the blood.

Your kidneys filter waste from your blood. Conditions like diabetes, heart disease, and high blood pressure can stress your kidneys, increasing the risk of chronic kidney disease (CKD), which is the gradual loss of kidney function.

Maintaining a healthy weight through exercise and a balanced diet helps reduce this risk. Fruits and vegetables are vital for a healthy diet, but some are also high in potassium. In CKD, your kidneys may struggle to process excess potassium, leading to dangerously high blood levels.

Here’s how to manage potassium if you have or are at risk of CKD.

Potassium is a mineral that helps your body balance fluids and supports the function of your cells, nerves, and muscles. It’s found in varying levels in many foods, especially fruits and vegetables.

It’s important to have the right balance of potassium in your blood. Levels should generally remain between 3.5 and 5.0 milliequivalents per liter (mEq/L).

Getting enough potassium in your diet supports the muscles controlling your heartbeat and breathing.

It’s also possible to consume more potassium than your kidneys can filter from your blood, which can cause abnormal heart rhythms.

CKD increases your risk of high blood potassium levels, known as hyperkalemia. It’s important to monitor your potassium intake if you have CKD.

Your kidneys remove excess potassium from your blood and excrete it in your urine. CKD can reduce your kidneys’ ability to eliminate extra potassium in your bloodstream.

Untreated hyperkalemia interferes with electric signals in the heart muscle. This can lead to potentially dangerous abnormal heart rhythms.

Keep in mind that other factors can increase your risk of hyperkalemia. For example, medications used to treat high blood pressure (beta-blockers and blood thinners) can cause your kidneys to hold on to extra potassium. Other medications that may increase your risk include potassium-sparing diuretics, ace inhibitors, blood thinners, and beta blockers.

Many people notice few, if any, signs of hyperkalemia. High potassium levels can develop gradually over weeks or months.

Symptoms can include:

  • muscle weakness
  • abdominal cramps
  • nausea
  • numbness or tingling
  • a weak or irregular heartbeat
  • diarrhea
  • fainting

Sudden and severe high potassium levels may cause:

  • chest pains
  • heart palpitations
  • shortness of breath
  • vomiting

It can be life threatening. Call a doctor immediately if you experience these symptoms.

If you have CKD, your doctor may recommend incorporating low potassium fruits and vegetables into your diet.

It’s also important to eat these foods as part of a healthy diet to maintain a moderate weight. A registered dietitian can help you find the right balance.

Low-potassium fruits and vegetables to include are:

  • apples
  • bell peppers
  • berries
  • cranberries
  • grapes
  • green beans
  • mushrooms
  • onions
  • peaches
  • pineapple
  • watermelon
  • zucchini

Do keep in mind that the serving size or portion that you have of these fruits and vegetables is important to maintain low potassium.

Fruits and vegetables you may need to limit are:

  • asparagus
  • avocados
  • bananas
  • cantaloupe
  • cooked spinach
  • dried fruit such as prunes and raisins
  • honeydew melon
  • kiwis
  • nectarines
  • oranges
  • potatoes
  • tomatoes
  • winter squash

Other tips to maintain a healthy potassium blood level with CKD include:

  • Cutting back on dairy products or choosing dairy alternatives like rice milk.
  • Avoiding salt substitutes.
  • Reading food labels for potassium levels and paying attention to serving sizes.
  • Maintaining a regular dialysis schedule.

Your doctor may recommend the following strategies to help you maintain a healthy potassium level:

  • Low potassium diet. Work with your doctor or a dietitian to create a meal plan.
  • Diuretics. These medications help expel excess potassium from your body through your urine.
  • Potassium binders. This medication binds to excess potassium in your bowels and removes it through your stool. It’s taken by mouth or rectally as an enema.
  • Medication changes. Your doctor may change the doses for heart disease and high blood pressure drugs.

Always talk with your doctor before stopping, starting, or changing the dosage of medications or supplements.

Potassium is an important mineral for nerve, cell, and muscle function, but it’s also possible to get too much potassium.

Kidney damage from CKD can affect how well your kidneys remove extra potassium from your blood. High levels of potassium in the blood can be dangerous.

If you have CKD, talk with your doctor about what a healthy diet looks like for you and whether medications can help manage your potassium levels.