Potassium Too High

[PrimeTimer]

Aside from diet changes, how can you lower your potassium?  A repeat blood test shows my husband's potassium is too high at 6.2. We think we know where we went wrong...sunflower seeds on salad and a bowl of oatmeal. Do they ever medically do something for high potassium, some sort of treatment or just diet changes? Thanks. 

[kristina]

Hello PrimeTimer,
I am sorry for this concerning Potassium-reading and to my knowledge
the Potassium within the diet needs to be watched very closely.
I wish you both good luck from Kristina.

[justagirl2325]

I know my guy has a powder at home for emergencies.  If for some reason he is unable to dialize as expected (power failure at home) and he knows he has eaten potassium rich foods he can take it.  And he has a couple of times.  I will look at it and pass on the name.

Other than that with the Baxter machine they regulate potassium with the bath that they use on dialysis.  He started out with a higher potassium bath, then lower and they may lower it again next prescription that would help his levels and allow him to eat more potassium.

[trenton6013]

I can't remember the name, but for awhile I was taking a thick liquid bottle to lower my potassium when mine was upwards around 13.

[cassandra]

The powder is called Calcium Resonium, and works pretty good, even when drs will tell you it doesn't (UK).

Also sodium binds K+, so if you don't have a problem with raised BP, increasing those could bring it down a bit.

This is all just me and my opinion, and experience personally.

Good luck, and love, Cas

[PrimeTimer]

Thanks for the responses, everyone. I know too high or too low of a potassium level can be dangerous so wanted to get on it right away. His labs are usually very good so this caught us both off guard. The oatmeal was my fault...he was constipated and without thinking, I suggested what we had in the cupboard and that was the oatmeal. Dummy me! I should've remembered oatmeal isn't good for him but it totally slipped my mind. The sunflower seeds surprised both of us. He had a salad at a cafeteria and they sprinkled sunflower seeds on it. Who would've thought a few seeds could be your enemy? When he thought back to what he's eaten, the seeds and oatmeal were the two things that stood out. Luckily he sees the dietitian and probably the neph again tomorrow. Hopefully all this is just diet-related. Funny how oatmeal can be good for your heart in the way of lowering cholesterol but if you have kidney disease, it is NOT good for you!

[PrimeTimer]

I know my guy has a powder at home for emergencies.  If for some reason he is unable to dialize as expected (power failure at home) and he knows he has eaten potassium rich foods he can take it.  And he has a couple of times.  I will look at it and pass on the name.

Other than that with the Baxter machine they regulate potassium with the bath that they use on dialysis.  He started out with a higher potassium bath, then lower and they may lower it again next prescription that would help his levels and allow him to eat more potassium.

Thanks for the info, justagirl! I revisited your post and it got me thinking....When he was doing home-hemo using NxStage, the "K" in his dialysate bath was K1. Since he's been doing in-center, we have no idea what they are using on him. He's going to bring this up with the neph.

[LorinnPKD]

Was just about to comment on the bath!  My potassium has been creeping up and my neph adjusted the bath for one with lower potassium. If that's applicable for you, it's an easy change-- they just swapped out one jug for another.

[Charlie B53]

Funny how oatmeal can be good for your heart in the way of lowering cholesterol but if you have kidney disease, it is NOT good for you!

Qwap!   And I like oatmeal.   Here is another one I got to drop or only rarely eat.

While on PD I was always told  "Eat more....."   Switching to Hemo is a HUGE difference in Diet.

Thanks for the tip.  As a 'Guy' of course I rarely read ingredients or the nutritional info.

When will I learn?

[smartcookie]

We prescribe kayexalate for patients with high potassium at my clinic.  We also check baths and stuff.  For very high potassium, 7+, we usually send the patient to the hospital for them to get it down.  Hope this helps!

[PrimeTimer]

Update:
His neph thinks he might not be getting enough good dialysis and that it's time for another angioplasty in his fistula. She doesn't think it's the dialysate bath because he's been on the same one for so long with no problems. Of course, the oatmeal didn't help matters either. They made him an appt next week to see the vascular surgeon.

One sign that his fistula needs angioplasty is when they go to pull the venous needle there is some leakage around the arterial needle from pressure inside. I remember when we were still doing home-hemo this would happen on occasion and sure enough, it was time for an angioplasty (balloon). A relatively quick fix. He has these done every few months or so but the balloon jobs help keep his fistula alive and working. Just never occurred to me that a narrowing or blockage of a fistula could affect lab tests. 

[Charlie B53]

Ah, the restriction in the path does make sense when I think about for a minute.  The blood flow was recirculating rather than passing on into his body.  Enough he kept dialysing the same blood over and over again.   That would be a hard one to figure out, short of noticing his labs.  This is a lesson for all to remember.

[Riki]

A few years ago, my potassium jumped from where it normally is, which is hovering between 3 and 4, to 8.  I knew it was dietary, because it was just so abnormal.  I couldn't think of what it was that I'd done.  When I told the dietician that I'd had a craving for pink lemonade, and had drank about a half gallon of it in the 2 weeks prior to bloodwork, she looked at me and laughed, saying, "that's gotta be it."  It never even dawned on me that lemonade could mess with phosphorus levels, but it is a citrus fruit and they are high in potassium.  Since then, I've limited my lemon intake to lemon meringue pies and flavoring for iced tea. *G*

[kitkatz]

https://draxe.com/top-10-potassium-rich-foods/
http://www.webmd.com/food-recipes/tc/high-potassium-foods-topic-overview

A couple of site overviews of high, med and low potassium foods.

[PrimeTimer]

https://draxe.com/top-10-potassium-rich-foods/
http://www.webmd.com/food-recipes/tc/high-potassium-foods-topic-overview

A couple of site overviews of high, med and low potassium foods.

Thanks for the links. I just printed them. Especially like the first link because it includes potassium amounts with portion size. This will help.

[kitkatz]

Suggestions:  Make a list of everything in your cupboards and fridge and freezer.  Then look at the potassium list and then start to eliminate things in your cupboards out of your diet.  Replace the high potassium things with lower potassium things.

[Charlie B53]

Oh Man!  That list of Top 10 Potassium Rich Foods sure opened my eyes.

The first three have been very high on my diet while on PD but my numbers remained fine.

Now on Hemo that has GOT TO change!    And #10 Mushrooms.   How can I cook most any meat without them?

This is going to be a SERIOUS learning experience.    Now wonder my Phos has jumped from 3.2 on PD to SEVEN on Hemo.

How bad is 7?   I've never been over 3.5 before.  I know next to nothing, yet.   Learning curve is pretty steep.   LOL

I once had a signature line in an old motorcycle forum.

Charlie B
Leaning Hard into the Learning Curve.

I may have to start using that again.

[kickingandscreaming]

Now wonder my Phos has jumped from 3.2 on PD to SEVEN on Hemo. How bad is 7?

Phosphorus of 7 is pretty bad if it persists.  It usually means you're not taking enough binders for what you're eating.  PD is really good at clearing potassium, but hemo isn't.  Before, when you were on PD, you had long dwells.  According to my neph, there is a certain minimal optimal duration of a dwell for clearing the large molecules such as phosphorus.  Now you don't have that.

[kitkatz]

BINDERS DO NOT CLEAR POTASSIUM!   They clear PHOSPHOROUS!

[Riki]

BINDERS DO NOT CLEAR POTASSIUM!   They clear PHOSPHOROUS!

Right..  The only "binder" I know of that clears potassium is Kayexalate, and that stuff is nasty.  It's a thick liquid that you have to drink, and it's usually close to half a litre of if you need to drink for it to be effective.  It's brown, and looks like muddy water, also has the same texture of muddy water when you drink it, like drinking wet sand.  I haven't had it since I was about 14.  I don't know if it's used as often with the adults as it is with the kids.

[Charlie B53]

I've been learning to take my Binders far better.  Almost to the point of taking them with EVERYTHING.  I is a major change from PD.  Then I only took them when eating Chili and my Phos stayed right at 3.2 to 3.5  Now on Hemo WITH binders I am 7.  No symptoms yet.

Potassium I will have to see what labs come back as.  PD I was again averaging 3.2  No idea yet now.  I am learning to be far more careful selecting my foods.

Still hoping to go back on PD in another couple three months.  Will just have to wait and see.

[smartcookie]

High phosphorus usually isn't a problem if it is for a month or so.  But if it is above 5.5 for many months, it can cause serious issues.  Calcium and phosphorus are buddies in the body.  If you have too much phosphorus, calcium is leached from your bones, causing your bones to become weak and brittle.  Then the calcium can be deposited in your organs, including your heart and skin.  This causes your organs to not be elastic.  They become "crunchy" and things happen like the heart becoming weak and not pumping blood as well and sores on your skin.  A short term symptom of high phosphorus is itchy and dry skin.  That is the most common one.  Sometimes when you start hemo from PD, you will need to up your binder dose or watch your diet more carefully.  Ask your dietician for more information. 

[PrimeTimer]

Update on my husband:

He had a fistulagram this morning. He didn't need an angioplasty. Vascular surgeon said his fistula looks "beautiful" (their word to describe a nicely working fistula). So, now it's back to the drawing board. They did a third blood draw last week so hopefully will have good news for him at dialysis tomorrow. Meantime, he has cut out as much potassium as humanely possible. 

[smartcookie]

Glad his fistula is working, but I know you are frustrated that you don't know what is causing it.  Could they be putting the needles to close together? 

[PrimeTimer]

Glad his fistula is working, but I know you are frustrated that you don't know what is causing it.  Could they be putting the needles to close together?

He has used the same buttonholes for over a year now with no increased potassium level. They called and it is still high at 6.0 but down from 7.0 6.2 so shows some improvement. Curious what his neph will have to say since the problem isn't with his fistula.


*self corrected to reflect potassium was at 6.2