Table of Contents
- Introduction
- Potassium’s Role in the Body and when is Potassium a Concern
- Managing Potassium Safely
- Conclusion
- References
Introduction
IgA Nephropathy (IgAN) is an autoimmune form of kidney disease where IgA immune complexes build in the kidneys and cause damage. Typical symptoms include protein and blood in the urine. Not everyone with IgAN initially has kidney damage. This process is very different than someone who has chronic kidney disease (CKD) not related to the immune system. It also means that people with IgAN may not necessarily have other symptoms of CKD like high potassium. This article reviews potassium’s role in the body, why it is a concern, and how to make changes if you need to restrict potassium.
Potassium’s Role in the Body and when is Potassium a Concern
Potassium helps to regulate blood pressure, nerve function, and muscle contraction (1). When blood potassium is too high or low our nerves and muscles may not function as they should. This can lead to irregular heartbeats or heart attack (2). There are very little to no symptoms of high potassium before irregular heartbeat occurs. For this reason, traditionally low potassium diets were recommended for all people with any kind of CKD. In 2020, the National Kidney Foundation guidelines were updated and the recommendation for a low potassium diet was also updated.
The current guidelines for all people with CKD is to limit potassium only if blood potassium is high (3).
A high potassium intake when paired with a low sodium diet has been shown to help reduce blood pressure and support heart health. High blood potassium is also more frequently seen in later stages of CKD. Early stages of IgAN kidney disease may not require a potassium restriction especially if potassium is in range.
Certain medications that are commonly used to protect kidneys side effect is a higher likelihood of high potassium (hyperkalemia). Medications such as ACE inhibitors, ARBs, potassium-sparing diuretics and certain cholesterol medications can raise blood potassium.
The body removes some potassium in stool. Constipation can increase blood potassium. Preventing constipation by eating more fiber can be helpful in balancing potassium. Many foods that are high in fiber are also good sources of potassium. The potassium in high fiber foods is often not as absorbable as the potassium in low fiber foods.
For all the reasons listed above, potassium intake is highly personalized and seeing a renal dietitian and confirming your potassium needs with your healthcare team is recommended.
Managing Potassium Safely
When a low potassium diet is needed there are several eating strategies that can make this way of eating easier:
- Limit juices and smoothies with high potassium sources.
- Avoid salt substitutes and foods with potassium additives such as potassium chloride.
- Eating high potassium foods multiple times such as in when eating leftovers.
- Eating large portions of animal protein (meat contains potassium and no fiber).
- Choose mostly lower and medium potassium foods and then smaller portions of high potassium choices.
- Soak canned or fresh beans overnight to leach out potassium.
- Double boil root veggies like potatoes to reduce potassium.
Conclusion
Potassium intake for people with IgAN is highly personalized. Not everyone needs a potassium restriction and checking with your doctor and dietitian is important. Potassium needs often change over time based on overall kidney function and medications needed. Renal dietitians can help make following a IgAN diet easier. If you are struggling with how to cope with IgAN, the IgAN foundation hosts events on nutrition and more.
References
- NIH. (2016). Office of Dietary Supplements – Potassium. Nih.gov. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/
- Yamada, S., & Inaba, M. (2021). Potassium Metabolism and Management in Patients with CKD. Nutrients, 13(6), 1751. https://doi.org/10.3390/nu13061751
- Ikizler, T. A., Burrowes, J. D., Byham-Gray, L. D., Campbell, K. L., Carrero, J. J., Chan, W., Fouque, D., Friedman, A. N., Ghaddar, S., Goldstein-Fuchs, D. J., Kaysen, G. A., Kopple, J. D., Teta, D., Yee-Moon Wang, A., & Cuppari, L. (2020). KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. American journal of kidney diseases : the official journal of the National Kidney Foundation, 76(3 Suppl 1), S1–S107. https://doi.org/10.1053/j.ajkd.2020.05.006
