Low Potassium and Phosphate Diet

When your kidneys are not working as well as they should levels of potassium and phosphate in the blood can build up.

High potassium levels can affect the way the heart beats and high phosphate levels can cause itchy skin, leg pain. Long-term, it can cause a build-up of mineral deposits leading to heart disease.

Choosing lower potassium and phosphate foods can help lower your / your child’s blood levels. The foods listed below have been split into three categories to help you choose foods that contain less potassium and phosphate and how often you can have them.

The categories are:

• Foods lower in potassium and phosphate – can have daily
• Foods moderate in potassium and phosphate – can have twice a week or as advised within the list
• Foods high in potassium and phosphate – avoid or limit to once a week

Meat and fish

Foods lower in potassium and phosphate – can have daily

• Ideally a fist sized portion or about 50g
• Fresh, unprocessed beef, lamb, pork, chicken, turkey
• Homemade chicken, turkey in breadcrumbs 
• Homemade burger
• Fresh, unprocessed fish (cod, haddock, salmon, hake, halibut)
• Homemade fish in breadcrumbs or fish cakes
• Homemade meat or chicken pie
• Shepherd’s pie*
• Stew or casserole*

* See ‘additional information‘ further down this page

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Squid / calamari in batter
• Tomato based meals (e.g. lasagne, spaghetti bolognaise, tomato based curry)

Foods high in potassium and phosphate – avoid or limit to once a week

• Processed / convenience foods e.g. sausages, sausage rolls, chicken nuggets, 2 x fish fingers, 1 x fish cake, microwaveable burger
• Take away meals e.g. beef burgers, deep fried chicken / fish in batter 
• Fish tinned in tomato sauce 
• Cured meats e.g. bacon, pepperoni, salami
• Cold meats e.g. sliced ham, sliced chicken, Spam
• Anchovies, monkfish, seabass, smoked salmon, smoked mackerel, swordfish

Non-meat protein alternatives

Foods lower in potassium and phosphate – can have daily

• Quorn pieces 
• Tofu (100g – steamed only)
• Hummus – any flavour (max. 30g / day)

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Tahini paste (1 tablespoon)

Foods high in potassium and phosphate – avoid or limit to once a week

• Quorn mince
• Tofu (fried)
• Baked beans
• Aduki beans, black eyed beans
• Nuts, seeds
• Processed bean burger, processed nut roast, processed veggie-burger, processed veggie-sausages
• Lentils, butterbeans, chickpeas, soya beans (50g). These can be eaten more frequently if eaten as an alternative to meat

Dairy foods

Foods lower in potassium and phosphate – can have daily

• Cream (double / single) 
• Soft cheese (full fat) e.g. Philadelphia
• Cottage cheese (50g)
• Cream cheese e.g. ricotta, mascarpone (50g)
• Crème Fraiche (50g)
• Egg whites
• Tzatziki (1 tablespoon)

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Milk based desserts: a small portion (50-80g) e.g. custard, rice pudding, Lassi (50g)
• 1 x 100g pot of plain yogurt or 1 x 60g pot of fromage frais
• Milk or milk alternatives – no more than 100mls daily

Foods high in potassium and phosphate – avoid or limit to once a week

• Processed cheese e.g. cheese slices, spreadable cheese
• Whole egg or egg yolk
• Condensed milk
• Evaporated milk
• Dried skimmed milk
• Milk powders
• UHT milk
• Greek yogurt
• Ice cream / ice cream bars
• Crème caramel

Vegetables 

All vegetables contain potassium, however some contain more than others. It is important to continue to eat these as part of a healthy balanced diet, however choosing lower potassium options and limiting to 2-3 small portions a day will help control your potassium levels (a portion is 1-2 tablespoons or a small bowl of green salad). 

See ‘additional information‘ further down this page for cooking information.

Foods lower in potassium and phosphate – can have daily

• Carrots
• Swede
• Leeks
• Frozen mix of carrots, peas and sweetcorn
• Green peppers
• Cucumber
• Iceberg lettuce
• Onions (raw or boiled)
• Gherkins
• Beansprouts
• Green pesto (1/4 jar)
• Hummus – any flavour (50g)

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Aubergine
• Cauliflower
• Green beans
• Broccoli
• Cabbage
• Courgettes
• Sweetcorn
• Peas (frozen and mushy)
• Broad beans
• Lettuce (60g)
• Sweetcorn (60g)
• Spring or fried onion

Foods high in potassium and phosphate – avoid or limit to once a week

• Potato / sweet potato
• Tomatoes (fresh and canned), passata, tomato puree, tomato based sauces e.g. pasta sauce
• Baked beans, Kidney beans, tinned vegetables
• Mushrooms, Spinach, Beetroot, Brussels sprouts, Asparagus, Butternut squash, Celeriac, Celery, Okra, Plantain, Yam, Parsnip
• Tofu (fried) 

Fruit

All fruits contain potassium, however some contain more than others. It is important to continue to eat these as part of a healthy balanced diet, however choosing lower potassium options and limiting to two small portions a day will help control your potassium levels. 

Foods lower in potassium and phosphate – can have daily

• Apple
• 10 x cherries
• ½ grapefruit (canned in juice) 
• Pear
• Satsuma / clementine 
• 10 x raspberries 
• 12 x blackberries

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Apricot (small)
• Plum
• 10 grapes
• 5 strawberries
• Raisins / sultanas (small box – 15g)
• Small orange
• Blueberries (40g)
• Lime / lemon
• Peach (canned in syrup)
• One small tin of fruit in syrup (150g if eaten without the syrup or 200g if eaten with the syrup)

Foods high in potassium and phosphate – avoid or limit to once a week

• Banana, avocado, guacamole, rhubarb, melon (honeydew, galia, cantaloupe, water melon), large orange, damsons, blackcurrants, gooseberries, star fruit, mango, kiwi, pineapple
• All dried fruit e.g. currants, apricots, figs, dates
• Sweet mincemeat
• Fruit juice

Starchy Foods 

See ‘additional information‘ for information on cooking.

Foods lower in potassium and phosphate – can have daily

• Sliced bread 
• Pitta bread, bagels, croissants, chapatti, paratha (check ingredients for phosphate additives)
• Rice, pasta, plain noodles, cous cous
• Dumplings 
• Savoury crackers e.g. cream crackers, crispbread
• Bread sticks
• Breakfast cereals, e.g. cornflakes, Rice Krispies, Weetabix (x1), Frosties, Cheerios, Shreddies, Sugar Puffs, puffed wheat
• Porridge oats made with water

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Boiled or mashed potatoes (not instant) or sweet potato – one serving per week
• Yorkshire pudding (large)
• Granary bread

Foods high in potassium and phosphate – avoid or limit to once a week

• Potatoes – steamed potatoes, roast potatoes, jacket potatoes, new potatoes in skin, sauté potatoes
• Manufactured potato products – hash browns, potato waffles, potato bread, croquettes, frozen roast potatoes, potato wedges, smiley faces / alphabet letters, gnocchi
• Tinned pasta in tomato sauce
• Pizza 
• Snack pot / instant noodles
• Bran Flakes, All Bran, oat bran, Ready Brek
• Weetos, Coco Pops, Crunchy Nut, any cereal containing fruit or nuts e.g. fruit and fibre, muesli, sultana bran, Raisin Wheats
• Baked goods containing phosphate raising agents (baking powder) e.g. crumpets, English muffins, scones, naan bread, tortilla wraps, Scotch pancakes, malt loaf, wheaten bread 
• Cake mixes
• Rye crispbread e.g. Ryvitta, Oatcakes, seeded crackers, cheesy biscuits

Puddings and sweet things

Foods lower in potassium and phosphate – can have daily

• Pie or crumble – any fruit used should be tinned in syrup
• Doughnut, jam tart, shortcake, cream biscuits e.g. custard cream, Jammie Dodgers, Party Rings, wafer biscuits 
• Plain biscuits e.g. digestive, rich tea
• Sponge cake e.g. Madeira cake, lemon drizzle cake, sponge cake with cream or jam filling, Swiss roll, Fondant Fancies
• Jelly (include in fluid allowance)
• Meringue
• Sugar, jam, honey, marmalade
• Sweets e.g. mints, barley sugar, Jelly Babies, jelly beans, Jelly Tots, Randoms, Fruit Pastilles, Fruit Gums, Fruit-tella, Chewits, Midget Gems, Love Hearts, Polos, Mentos, Skittles, Haribo jelly sweets, boiled sweets, marshmallows, Turkish delight (no chocolate)
• Lollies e.g. Chupa Chups, Drumstick, Swizzels Double Lolly, Push Pop, Sherbet Dip
• Popcorn

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Crepes
• Toffees (50g)
• Chocolate covered animal biscuits
• Milky Way
• Smarties
• Crunchie
• Kit Kat (2 finger bar) / Blue Riband
• White chocolate buttons (small bag)
• Crème Egg

Foods high in potassium and phosphate – avoid or limit to once a week

• Plain / milk / white chocolate (small bar- 50g)
• Mars Bar
• Twix (2 fingers)
• Bounty
• Cakes and biscuits containing dried fruit, nuts, coconut, coffee, chocolate 
• Black treacle, chocolate spread, peanut butter
• Eccles cake
• Bread & butter pudding
• Chocolate, toffee, fudge
• Liquorice
• Marzipan

Savoury Snacks

Foods lower in potassium and phosphate – can have daily

• Plain popcorn
• Prawn crackers (30g)
• Corn and maize snacks e.g. Monster Munch roast beef flavour, Space Raiders, Mini Cheddars, Hoops and Crosses (not salt and vinegar), Sunbites, Velvet Crunch, tortilla chips

Note: Some corn and maize snacks contain potassium chloride. You should try to avoid these if possible. Supermarket own brand versions may not contain potassium chloride, so check the label.

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

Note: the following corn snacks contain potassium chloride:

• Skips, Wotsits, Wheat Crunchies, Frazzles, Nik Naks, Hoops and Crosses (salt and vinegar flavour), Monster Munch (Flamin’ Hot or Pickled Onion flavour)

Foods high in potassium and phosphate – avoid or limit to once a week

• Potato crisps – all flavours
• Walkers, Discos, French Fries, Quavers, Hula Hoops, Squares, Spirals, Pom Bears
• Salted popcorn, Bombay mix
• Nuts

Drinks

Foods lower in potassium and phosphate – can have daily

• Water
• Squash / Cordial (<10% fruit juice from concentrate)
• Clear fizzy drinks (Sprite, Irn Bru, 7Up, Lemonade)
• Iced tea
• Decaf tea

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Coffee (2g instant – black)
• Some fizzy drinks (Tango/Fanta 330ml)

Foods high in potassium and phosphate – avoid or limit to once a week

• Fresh fruit juice / Smoothies
• Tomato juice
• Robinsons Fruit Creations
• Ribena, high juice squash
• Isotonic and sport drinks e.g. Lucozade Sport / Lucozade Energy / Gatorade
• Relentless
• Dark fizzy drinks (Coke, Dr Pepper, Pepsi, Dandelion & Burdock, Vimto)
• Drinking chocolate, cocoa, Horlicks, Bovril
• Milkshakes

Note: Children under 12 years should not have caffeine containing drinks

Miscellaneous

Foods lower in potassium and phosphate – can have daily

• Salad cream, mayonnaise (max. 2 tablespoons)
• Coleslaw (1 tablespoon)
• Butter, margarine, cooking oil, olive oil
• Yeast
• Bicarbonate, cream of tartar

Foods moderate in potassium and phosphate – can have twice a week or as advised within the list

• Gravy*, soup* (except tomato and mushroom)
• Tomato ketchup – no more than one dessertspoon per day 

Foods high in potassium and phosphate – avoid or limit to once a week

• Mushroom soup, tomato soup
• Salt substitutes e.g. Lo Salt, So-Low, Reduced Sodium
• Pickles and sauces e.g. brown sauce, pickled onions, Branston pickle, piccalilli, beetroot
• Marmite, mustard
• Desiccated coconut
• Packet cheese sauces
• Baking powder

Additional information

• Potatoes and vegetables should be boiled rather than steamed, microwaved or roasted. This helps to “wash out” some of the potassium
• Use a large volume of water to boil potatoes and vegetables. Throw the water away, don’t use it for making gravy
• All vegetables and potatoes should be peeled before cooking
• No extra vegetables should be served if vegetables are included in the main dish e.g. stew or casserole
• Curry contains more potassium than other meat dishes and so should be served with rice or chapati, not potato

Phosphate Additives 

Phosphate can be added to your food (phosphate additives) to add flavour, colour or to extend the shelf life of the product. These are easily absorbed by the body and can significantly increase your phosphate blood levels. 

Phosphate additives tend to be added to processed foods such as processed cheeses, processed meats e.g. sausages; frozen products e.g. chicken nuggets; fizzy drinks e.g. Coca-Cola and some bakery products e.g. naan bread.

Phosphate additives are included in the ingredients list, either by name or E number:

E338 Phosphoric acid 

E339 Sodium phosphates

E340 Potassium phosphates 

E341 Calcium phosphates 

E343 Magnesium phosphates

E541 Sodium aluminium phosphate

E450 Diphosphates

E451 Triphosphates

E452 Polyphosphates

Checking food labels 

Look for any of the above phosphate additives on your food label and avoid any foods that contain the additive(s). For example:

Chicken nuggets –

Ingredients: Chicken Breast (51%), Breadcrumbs (Wholemeal Wheat Flour (7%), Wheat Flour, Fortified Wheat Flour (Wheat, Calcium phosphate, Iron, Niacin, Thiamin), Salt, Yeast, Paprika, Turmeric), Rapeseed Oil, Water, Fortified Wheat Flour (Wheat, E451, Iron, Niacin, Thiamin), Flour (Maize, Rice), Salt, Wheat Starch, Cornflour, Natural Flavouring, Onion Powder, Garlic Powder

Tips on taking your phosphate binder

• Check with your doctor, pharmacist or dietitian when is the best time to take your binder as this can vary depending on which one has been prescribed
• Avoid taking at the same time as your iron supplement 
  (if prescribed)