Potassium

Question 1

Potassium plays an important role in … and controlling …

Answer 1

Muscle contraction and heart rhythm

Question 2

Potassium levels are controlled by … and excess is excreted in …

Answer 2

Kidneys and urine

Question 3

High levels (hyperkalaemia) can cause … (4)

Answer 3

Muscle weakness
Cardiac arrhythmias
Cardiac arrest
Paralysis

Question 4

Low levels (hypokalaemia) can cause …

Answer 4

Cardiac arrhythmias

Question 5

High or low levels of potassium often have … symptoms

Answer 5

No

Question 6

Normal blood range for potassium

Answer 6

3.5 - 5.5 mmol/L

Question 7

Causes of high potassium

Answer 7

Most common cause = reduced kidney function
Other causes:
Medications
Muscle breakdown
Heart failure
Poor diabetes control
High dietary intake
Constipation

Question 8

Most common cause of high potassium is …

Answer 8

Reduced kidney function

Question 9

Low potassium diet

Answer 9

Impossible to have potassium free diet
Found across all food groups
Generally 1mmol/kg IBW
Individual advice
Remove non-nutritious sources first

Question 10

Inappropriate restriction results in reduced dietary … and …

Answer 10

Variety and constipation

Question 11

Foods high in potassium

Answer 11

Salt substitutes (potasssium chloride)
Peanut butter
Yeast extract
Coffee
Malted drinks
Bombay mix
Potato, tomato or vegetable soups
Bread and cereals
Milk unboiled potato products
Nuts
Chocolate
Fudge and toffee
Cakes and biscuits

Question 12

Fruits and vegetables

Answer 12

Limit to 5 portions of fruits and vegetables per day
Choose options from lower potassium items
Potassium also excreted in stool
Want to encourage fibre and avoid constipation
Emphasis on portion sizes

Question 13

Boiling vegetables

Answer 13

Causes potassium to leach out into water
Discard water and do not use to make soups, gravy or sauces
Avoid using a microwave, steamer or pressure cooker
Par boil vegetables before using other cooking methods

Question 14

Bread, cereals, rice and pasta

Answer 14

Bread, rice, pasta, couscous and noodles are low in potassium
Limit seed/nut/dried fruit containing varieties of breads, grains and cereals
Can be used to bulk up meals to reduce potassium content

Question 15

Dairy

Answer 15

Limit cows milk and milk containing products
Limit to 300ml per day (important for fat, protein and calcium)

Question 16

Animal based protein

Answer 16

Beans and legumes restricted
Can use beans and legumes in place of meat (plant-based diets)
Cooking method - soaking or boiling beans and legumes

Question 17

Snacks and drinks

Answer 17

Enjoyment socially
Educate and provide alternatives
Sweets containing chocolate -> plain biscuits
Crisps -> rice cakes
Fruit and vegetable juices -> cordial or squash
Coffee -> tea
Beer/wine/cider -> spirits

Question 18

Potassium additives and preservatives

Answer 18

Often not on labels
Additive use increasing
Salt substitutes increasing to reduce sodium
Reduce intake of ultra-processed foods before fruits and vegetables

Question 19

Absorption of potassium additives is near …%

Answer 19

100%

Question 20

Hidden sources - additives

Answer 20

Difficult to calculate amount of potassium contributed
Potassium chloride in low salt products
Acesulfame K (E950) sweetener used in diet drinks doesn’t have to be limited

Question 21

Examples of potassium additives

Answer 21

Potassium chloride
Potassium carbonate
Potassium sulphate
Potassium phosphates

Question 22

Additives

Answer 22

Low potassium diet is very restrictive
Overwhelming to avoid all foods with potassium additives
Encourage reducing processed foods
Mindful of products that are likely to contain potassium additives (e.g. salt reduced products)

Question 23

Potential impacts of low potassium diet

Answer 23

Limited diet variety
Potential nutrient deficiencies
Constipation
Fixation on certain foods
Loss of enjoyment in foods or social activities
Difficulty following diet (low health literacy or cooking skills)

Question 24

Main conclusions of low potassium diet

Answer 24

Remove non-nutritious potassium foods first
Always provide an alternative
Review potassium levels to avoid unnecessary restrictions
Consider other dietary restrictions patient may have