Do you have chronic kidney disease (CKD) and were told to avoid nuts due to potassium?! Well, that is just NUTS! Potassium shouldn’t keep you from enjoying this healthy snack! In this blog post I’ll talk about potassium in relation to CKD and how you can enjoy nuts safely!
What is potassium?
Potassium is an essential mineral and electrolyte that plays many important roles in our body. It is primarily found inside our cells and maintains fluid balance, sends nerve signals, helps with muscle contractions and regulates blood pressure. We need potassium to keep our body functioning properly!
A normal potassium level is anywhere from 3.5 to 5 mEq/L. Both high and low blood potassium levels are associated with negative effects on the body. When your potassium is out of the normal range it can cause issues like irregular heartbeat and weakness.
Why does potassium matter with CKD?
The kidneys help keep potassium levels in balance. As kidney function declines, those with CKD may be at greater risk for hyperkalemia (high blood potassium). But not everyone with CKD will experience this. There are many factors that contribute to potassium building up in the blood.
Potential causes of high potassium with CKD include constipation, metabolic acidosis, certain medications and intake of potassium salts/potassium additives. There is a lot of research showing that dietary potassium intake from plant-foods, such as nuts, has little association with serum potassium! If you experience high potassium, ask your doctor what can be contributing to it outside of diet.
What are my potassium needs with CKD?
Per the National Kidney Foundation’s most recent evidenced-based clinical guidelines (Kidney Disease Outcomes Quality Initiative – also known as KDOQI) potassium recommendations should be individualized to maintain normal blood levels. This means if your potassium level is normal, there is typically no need to restrict.
A potassium restricted diet is typically around 2,000 mg potassium per day. Some people with CKD may benefit from up to 4,700 mg potassium which is the recommended amount for the average adult. Unsure where your potassium intake should fall? Working with a kidney dietitian can help you determine your potassium needs.
Nuts and Potassium
Nuts, being a plant food, are a source of potassium. Generally, a food that has >200 mg potassium per serving is considered “high” in potassium. Looking at the chart below, you will see many a few types of nuts are close to or over 200 mg per serving.
A serving of nuts is 1 oz which is about a handful of nuts or approximately ¼ to ⅓ of a cup. This isn’t a large amount. If you snack on nuts straight from the bag you can easily get multiple servings without even realizing it. This is why it’s beneficial to measure out your portion of nuts before you dig in! The number of servings of nuts to eat per day will vary based on your nutrition needs.
Potassium Content of Nuts
| Nut | Potassium per 1 oz of nuts |
| Macadamia | 104 mg |
| Pecan | 116 mg |
| Walnuts | 125 mg |
| Pine nut | 178 mg |
| Brazil nut | 187 mg |
| Cashew | 187 mg |
| Hazelnut | 193 mg |
| Peanut | 200 mg |
| Almond | 208 mg |
| Chestnut | 281 mg |
| Pistachio | 291 mg |
Summary
Potassium is needed for many vital functions in our body. With kidney disease, there is a risk of alterations in blood potassium levels. Many factors outside of diet can impact potassium levels. There is no need to avoid nuts with CKD! If you have to follow a low potassium diet be aware of your portions and you can enjoy safely.
