I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Diet and Recipes => Topic started by: Sugarlump on May 18, 2013, 07:39:32 AM

Title: I need help with reducing my potassium levels...
Post by: Sugarlump on May 18, 2013, 07:39:32 AM
Despite keeping to a fairly low potassium diet, I am struggling to get my potassium level down to an acceptable level. (7.3 this week pre dialysis, 3.9 post)
I eat a fairly normal english diet.
I usually have a cooked breakfast/light salad or sandwich lunch/cooked dinner. I try to limit my fluid to 1litre a day.
I don't eat fruit and only have 100-200 mls of apple juice a day.
I only have 1 cup of coffee a day.
I only eat crisps or chocolate during dialysis.
I usually have 2-3 portions of salad or lower potassium veggies a day.
I presoak my potatoes.

So what am I doing wrong? and what can I do to fix it? Dietician/nurses not much help. Tell me I must be eating high potassium food. But I can't figure
out what...
Help???  :urcrazy;
Title: Re: I need help with reducing my potassium levels...
Post by: PatDowns on May 18, 2013, 09:10:07 AM
Despite keeping to a fairly low potassium diet, I am struggling to get my potassium level down to an acceptable level. (7.3 this week pre dialysis, 3.9 post)
I eat a fairly normal english diet.
I usually have a cooked breakfast/light salad or sandwich lunch/cooked dinner. I try to limit my fluid to 1litre a day.
I don't eat fruit and only have 100-200 mls of apple juice a day.
I only have 1 cup of coffee a day.
I only eat crisps or chocolate during dialysis.
I usually have 2-3 portions of salad or lower potassium veggies a day.
I presoak my potatoes.

So what am I doing wrong? and what can I do to fix it? Dietician/nurses not much help. Tell me I must be eating high potassium food. But I can't figure
out what...
Help???  :urcrazy;

If you are getting a post dialysis reading of 3.9, then maybe you need to up your treatment time.  Also, see if you are running on a 2.0 potassium dialysate bath as opposed to a 3.0.  While you are doing the right thing by presoaking potatoes, how often are you eating them?
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 18, 2013, 09:16:17 AM
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Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 18, 2013, 09:27:58 AM
Despite keeping to a fairly low potassium diet, I am struggling to get my potassium level down to an acceptable level. (7.3 this week pre dialysis, 3.9 post)
I eat a fairly normal english diet.
I usually have a cooked breakfast/light salad or sandwich lunch/cooked dinner. I try to limit my fluid to 1litre a day.
I don't eat fruit and only have 100-200 mls of apple juice a day.
I only have 1 cup of coffee a day.
I only eat crisps or chocolate during dialysis.
I usually have 2-3 portions of salad or lower potassium veggies a day.
I presoak my potatoes.

So what am I doing wrong? and what can I do to fix it? Dietician/nurses not much help. Tell me I must be eating high potassium food. But I can't figure
out what...
Help???  :urcrazy;

If you are getting a post dialysis reading of 3.9, then maybe you need to up your treatment time.  Also, see if you are running on a 2.0 potassium dialysate bath as opposed to a 3.0.  While you are doing the right thing by presoaking potatoes, how often are you eating them?
Hi Pat.
They have changed my dialysate to a 1.0 potassium from a 2.0. I do 3 and a half hours x 3. I hate dialysis  >:(
As for potatoes, probably 4-5 times a week but I am not overkeen on rice, and don't like pasta so find it difficult to replace them... I wish I could find a decent menu plan/recipe book for dialysis patients.
All our dietician gives us is a leaflet telling us what to avoid...
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 18, 2013, 09:40:54 AM
G'day Sugarlump,


Your dietician/nurses are almost certainly right.



I can see one culprit immediately - crisps. Salted potato crisps are very high in potassium, (unsalted not quite as bad,) 1oz containing 450 to 500mg, -  about 4 times as much as a small bar of plain chocolate and about the same as eating a banana. A small chocolate bar is not so bad if eaten in moderation. Chocolate bars containing nuts can be significantly higher.


Secondly, eating these during dialysis would only help you if our bodies immediately digested and processed the food so that the potassium you just consumed was in the bloodstream and dialysis could remove it all at the same time, or at least during the four hour session.


Doesn't work that way, unfortunately.  :(


Quantities are also terribly important. 1 standard measuring cup of home cooked mashed potatoes can yield 900mg of potassium. That's a lot for a small quantity. While pre-soaking thin slices of potato and disposing of the water, then boiling and again disposing of the water does help, it Reduces, rather eliminates potassium.


By comparison, 1 large banana, which most renal diet charts tell us are to be avoided, has about 450mg potassium.


You need to get some really good advice, hopefully from your dietician, on the specifics of identifying potassium/phosphate etc, etc in your foods to be able to plan appropriate meals for renal failure.


It's very important to be aware that quantity can be  just as significant as the analysis. Someone else posted a while back, (Restorer?,) that we all need to become industrial chemists to cope with the renal diet.


If you don't have any success, let me know and I'll dig up the sources for the lists I use.


Henry p

hello Henry.I have been looking on the internet for an easy to use list of potassium values in food (actual amount rather than low, medium, high) as i realise there is a lot of variation between these groups and in portion sizes.
BUt but but I was under the impression (FROM THE NURSES!!!) That it was alright to eat higher potassium foods whilst on dialysis, e.g. crisps, bananas and orange juice but from what you say this isn't true???
I probably only eat 3 packets of crisps a week max and maybe 1-3 chocolate bars. I always get very hungry on dialysis (and bored) so tend to need to eat a fair bit of portable food hence crisps/chocolate etc.
I obviously need to reduce my potato intake.

Tonight I am cooking chicken tikka (left out the tomato paste) white boiled rice and cucumber raita.

Think I need to rethink my entire diet and what I eat during dialysis.
And maybe buy a set of scales (for portion size)...  :(
Title: Re: I need help with reducing my potassium levels...
Post by: Rerun on May 18, 2013, 09:47:07 AM
A 1K is good unless you happen to get the flu where you are not eating.  Then it will take too much Potassium off which is dangerous.  Too low of potassium is just as bad as too much potassium.  My unit won't use 1K at all.  At a different unit I was on 1K and did well just asking for 2K if I was not eating for some reason.  It is a delicate balanced dance.

Have your soaked potatoes maybe once a month the day of dialysis.  Soaked potatoes is not a license to eat as much and as often as you like.

Hope this helps....   :pray;
Title: Re: I need help with reducing my potassium levels...
Post by: iKAZ3D on May 18, 2013, 10:43:13 AM
G'day Sugarlump,


Your dietician/nurses are almost certainly right.



I can see one culprit immediately - crisps. Salted potato crisps are very high in potassium, (unsalted not quite as bad,) 1oz containing 450 to 500mg, -  about 4 times as much as a small bar of plain chocolate and about the same as eating a banana. A small chocolate bar is not so bad if eaten in moderation. Chocolate bars containing nuts can be significantly higher.


Secondly, eating these during dialysis would only help you if our bodies immediately digested and processed the food so that the potassium you just consumed was in the bloodstream and dialysis could remove it all at the same time, or at least during the four hour session.


Doesn't work that way, unfortunately.  :(


Quantities are also terribly important. 1 standard measuring cup of home cooked mashed potatoes can yield 900mg of potassium. That's a lot for a small quantity. While pre-soaking thin slices of potato and disposing of the water, then boiling and again disposing of the water does help, it Reduces, rather eliminates potassium.


By comparison, 1 large banana, which most renal diet charts tell us are to be avoided, has about 450mg potassium.


You need to get some really good advice, hopefully from your dietician, on the specifics of identifying potassium/phosphate etc, etc in your foods to be able to plan appropriate meals for renal failure.


It's very important to be aware that quantity can be  just as significant as the analysis. Someone else posted a while back, (Restorer?,) that we all need to become industrial chemists to cope with the renal diet.


If you don't have any success, let me know and I'll dig up the sources for the lists I use.


Henry p

hello Henry.I have been looking on the internet for an easy to use list of potassium values in food (actual amount rather than low, medium, high) as i realise there is a lot of variation between these groups and in portion sizes.
BUt but but I was under the impression (FROM THE NURSES!!!) That it was alright to eat higher potassium foods whilst on dialysis, e.g. crisps, bananas and orange juice but from what you say this isn't true???
I probably only eat 3 packets of crisps a week max and maybe 1-3 chocolate bars. I always get very hungry on dialysis (and bored) so tend to need to eat a fair bit of portable food hence crisps/chocolate etc.
I obviously need to reduce my potato intake.

Tonight I am cooking chicken tikka (left out the tomato paste) white boiled rice and cucumber raita.

Think I need to rethink my entire diet and what I eat during dialysis.
And maybe buy a set of scales (for portion size)...  :(

No, you should eat them BEFORE Dialysis. (Rather the hours before) It should be your meal before Dialysis if at all. That way it has had time to register in your bloodstream and it can be dialyzed out.
Title: Re: I need help with reducing my potassium levels...
Post by: Poppylicious on May 18, 2013, 10:55:36 AM
I wish I could find a decent menu plan/recipe book for dialysis patients.
All our dietician gives us is a leaflet telling us what to avoid...
Have you never been given Lawrence Keogh's "Rediscovering Food & Flavours" kidney care cookbook?!  I say cookbook, but it's not got a huge amount of recipes in it (only 16)!  Blokey was given it by the team at dialysis at A.  As I say, it doesn't have a lot in it and I was going to offer to send it to you but I just Googled and you can also download (or order) it from the Kidney Research UK website ...

http://www.kidneyresearchuk.org/health/free-recipe-book.php

It may give you some ideas anyway. 

 ;D
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 18, 2013, 10:59:39 AM
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Title: Re: I need help with reducing my potassium levels...
Post by: Zach on May 18, 2013, 11:40:46 AM
Hi Sugarlump,

Here are some links for recipes.
Hope you find these helpful.

PS:  There's always my chili recipe!
http://ihatedialysis.com/forum/index.php?topic=11916.0

 8)

http://www.kidney.ca/Page.aspx?pid=859

http://www.ultracare-dialysis.com/RecipeCenter.aspx

http://www.renalinfo.com/us/resources/recipes/index.html

http://www.davita.com/recipes/

http://www.aakp.org/education/brochures/item/aakp-nutrition-counter-a-reference-for-the-kidney-patient.html?category_id=27

http://ihatedialysis.com/forum/index.php?board=32.0
Title: Re: I need help with reducing my potassium levels...
Post by: Sydnee on May 18, 2013, 05:02:50 PM
I'm sure you already thought of this but thought I should ask anyway..

You have checked to make sure none of the medications you are on raise your potassium?
The only blood pressure medications that work for Ed raise his potassium.
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 18, 2013, 05:05:33 PM
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Title: Re: I need help with reducing my potassium levels...
Post by: Rerun on May 19, 2013, 08:10:49 AM
Also, watch your dairy products.  They are high in potassium and phosphorus.

     :P
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 20, 2013, 01:10:03 AM
G'day Sugarlump, - I found the link to the PDF's on the USDA site. It seems they've updated the layout since I was last in there, - big improvement.


http://www.ars.usda.gov/Services/docs.htm?docid=22769 (http://www.ars.usda.gov/Services/docs.htm?docid=22769)


also there's this:


http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/retn/retn06.pdf (http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/retn/retn06.pdf)





Its a file showing the effect of various types of cooking on vitamin and mineral composition of a range of foods.


There's a fascinating range of different ways of accessing nutrition information, - most of the choices are on this page:




http://www.nutrition.gov/whats-food/food-composition-finders[/u




Hope this helps,


Henry P
 (http://www.nutrition.gov/whats-food/food-composition-finders)

Thanks Henry. I spent yesterday afternoon creating my own typed up list of foods I eat from these lists, appropriate portion sizes and their potassium content.
Now i have the actual potassium values, rather than a rough guide (divided into high. medium, low) it is a lot easy to calculate how much potassium
I am actually eating... It's a bit of an eye opener really, I had always avoided strawberries (assuming them to be high) whilst continuing to eat my
soaked potatoes but they aren't actually that high. And why is avocado so high too!!!!
Read some scary stories on high potassium (that it can be fatal) so being really good now. Onwards and upwards...
I think my biggest problem was, starting dialysis again last year, for  the third time (after two failed transplants) I was really ambivalent about wanting to go
back on dialysis (especially knowing my chance of a third transplant is tiny) and not having good vascular access (femoral groin line only) that I haven't really
committed myself to being back on dialysis. The disappointmant of losing the last transplanted kidney battle still hangs heavy in my heart. I had the taste of freedom,
only to have it snatched back with little hope to look foward to.
Feelings of Is this as good as it gets... and Why me?
It get's harder each time around...  :rant;
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 20, 2013, 01:49:03 AM
I'm sure you already thought of this but thought I should ask anyway..

You have checked to make sure none of the medications you are on raise your potassium?
The only blood pressure medications that work for Ed raise his potassium.

Hi Sydnee
I did wonder about this as they changed my bp medication about 5-6 weeks ago and this is roughly the timescale i have had problems with my potassium.
I am now on Bisoprolol (as well as Lercanidipine and Doxazosin).
The Doc says no although it does mention as a rare side effect!!!
Maybe i am a raity!
Title: Re: I need help with reducing my potassium levels...
Post by: Zach on May 20, 2013, 03:43:02 AM
Hi Sugarlump,

Hope you are well.
Here is another site that has some renal friendly recipes:

http://www.rsnhope.org/recipes/

All the best!
8)
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 20, 2013, 03:56:41 AM
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Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 20, 2013, 10:17:08 AM
Hi Sugarlump,

Hope you are well.
Here is another site that has some renal friendly recipes:

http://www.rsnhope.org/recipes/

All the best!
8)

Thanks Zac (like the sound of The Shrimp Scampi - will have to try that)  ;)

PS> I just read your tag 31 YEARS on dialysis HELL I don't know how you've managed that. I am now in my 8th year and finding it hard going.
       You have my respect :)
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 20, 2013, 10:25:14 AM
G'day Sugarlump,  It can be really surprising just what is in some foods. Hopefully your blood results will see your potassium levels back in line again.


It must be emotionally hard starting dialysis yet again for the third time. ESRD can give us such a roller-coaster ride.
it's good to see you getting on and doing something positive.


Henry P

Dialysis and blood tests again today.
Results tomorrow.
Going food shopping tomorrow - that could be tricky!!!
I promise to take my lists and this morning we bought digital scales for weighing portions, so I can check sizes...
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 21, 2013, 08:51:07 AM
Hey blood tests results for yesterday
6.5 Potassium pre-dialysis.
Whilst this is still high, an improvement on 8!!!
So it's going in the right direction but I need to carry on being very diligent with my diet
Grateful for all the links to recipes/website info
Tonight (from the Davita site) we are having meatloaf and gravy!  :beer1;
Title: Re: I need help with reducing my potassium levels...
Post by: CebuShan on May 21, 2013, 03:30:39 PM
A good substitute for mashed potatoes is: mashed cauliflower! Make it like you would your potatoes. Not bad for a bit of a change!   ;D
Also, watch if you put cheese on your sandwiches. That can raise it also.
Good luck to you!
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 22, 2013, 12:47:16 AM
A good substitute for mashed potatoes is: mashed cauliflower! Make it like you would your potatoes. Not bad for a bit of a change!   ;D
Also, watch if you put cheese on your sandwiches. That can raise it also.
Good luck to you!

Not too sure about the mashed cauliflower!!!
But The Meat Loaf last night was wonderful  :2thumbsup;
I thought cheese was relatively low in potassium just high in phospate?
God I love cheese....
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 22, 2013, 11:42:43 AM
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Title: Re: I need help with reducing my potassium levels...
Post by: skg on May 22, 2013, 02:57:23 PM
A kilo of Colby! That!s good news. Giving up cheese has been one of my personal dread factors.
Title: Re: I need help with reducing my potassium levels...
Post by: Henry P Snicklesnorter on May 22, 2013, 03:27:16 PM
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Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 23, 2013, 01:22:14 PM
Personally I wouldn't consider cottage cheese as real cheese!!! That's something that comes in chunks!
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on May 30, 2013, 11:30:16 AM
Pre-dialysis potassium still 6.8 this week so despite diet modifications it isn't reducing much...
having took out crisps and milk (except in tea) and high-value veg/salad items ...
Trouble is they increased my prednisolone (steriods) for my skin condition which of course, increases the appetite.
I seem t have developed that condition where I keep opening the fridge door and stare in... (JJust looking not eating!)  :rofl;  :rofl;  :rofl;
Title: Re: I need help with reducing my potassium levels...
Post by: Restorer on June 06, 2013, 12:44:37 AM
How much tea are you drinking a day? I assume it can't be too much, given typical fluid restrictions (are you on any?), but tea has 80-100 mg of potassium per 8 oz. An ounce of milk adds another 40-50 mg.

How are you processing your potatoes? There's a study that shows that double-boiling potatoes removes as much potassium as presoaking with a change of water, then single-boiling. So that might save you time, to double-boil - use lots of water, put the potatoes in cold water, bring it to a full boil, then dump the water and replace with cold water, and bring back to a boil and cook until done. But emphasis on <b>thin slices</b> or grated potato. It won't take nearly as much out of cubes or chunks of potatoes.
Title: Re: I need help with reducing my potassium levels...
Post by: Sugarlump on June 06, 2013, 01:01:35 AM
How much tea are you drinking a day? I assume it can't be too much, given typical fluid restrictions (are you on any?), but tea has 80-100 mg of potassium per 8 oz. An ounce of milk adds another 40-50 mg.

How are you processing your potatoes? There's a study that shows that double-boiling potatoes removes as much potassium as presoaking with a change of water, then single-boiling. So that might save you time, to double-boil - use lots of water, put the potatoes in cold water, bring it to a full boil, then dump the water and replace with cold water, and bring back to a boil and cook until done. But emphasis on <b>thin slices</b> or grated potato. It won't take nearly as much out of cubes or chunks of potatoes.
:shy;

Hi Restorer.
Tea probably 4 small cups a day (about 100ml a time)...with a little milk and a sweetener added. (Due to fluid restriction otherwise would be a lot more!)

Never tried double boiling potatoes... are they not going to fall apart?!!! which is ok for mash but we currently in New Potato season so using the sweet, baby ones.
I usually soak for as long as possible, then change water to cook. I usually slice bigger potatoes or just halve the baby ones...
Make a lot of potato salad with mayo for salad this time of year. I usually take a salad in a little container for dialysis lunch, three days a week, as my time is 1pm-4.30pm and i don't like to eat beforehand.

I am not a great fan of sandwiches so it's difficult to find portable food that is also low in potassium ...  that I can eat one handed on dialysis easily enough!!!
Sausages and cheese are good!!!

 :beer1;