Chronic Kidney Disease (CKD), Potassium, and Phosphorus

You’ve probably heard that you should be mindful of your sodium intake to maintain the health of your kidneys, but some people with chronic kidney disease (CKD) may have to pay close attention to their potassium and phosphorus consumption as well. As CKD progresses, the kidneys lose their ability to filter out these essential minerals, potentially leading to additional symptoms and disease complications.
There isn’t one guideline that applies to everyone with CKD regarding how much potassium and phosphorus are safe. Recommendations differ depending on the individual, their stage of kidney disease, and their overall health. If you’re unsure how much potassium and phosphorus you should be consuming, consult your nephrologist, as well as a registered dietitian-nutritionist, for individualized guidelines.
Potassium and CKD
“Excess potassium concentrations can result in cardiac arrhythmias,” says Sumit Mohan, MD, a transplant nephrologist at NewYork-Presbyterian/Columbia University Irving Medical Center in New York City. “That’s the real worry with having a diet rich in potassium, since patients with CKD have an impaired ability to excrete potassium, especially in advanced stages.”
Potassium: The Expert Guidelines
What Foods Have the Most Potassium?
- Breaded chicken
- Chocolate
- Chocolate milk
- Coconut water and coconut milk
- Coffee (limit to 2 cups per day)
- Dairy and soy milk
- Dried fruit
- Fruit and vegetable juice
- Low-sodium processed foods like canned soup and pickles
- Potassium additives, such as potassium chloride, potassium phosphate, potassium lactate, and potassium citrate
- Potatoes, chips, and french fries
- Powdered drink mixes
- Processed meat (ham, hot dogs, bacon, deli meat)
- Sports drinks
- Tomato sauce and soup
Phosphorus and CKD
“When kidney function is impaired, excess phosphorus can accumulate in the blood, triggering the body to pull calcium from the bones,” says Los Angeles-based Jamie Mok, RD, a spokesperson for the Academy of Nutrition and Dietetics. The result can weaken bones and prompt calcium deposits in blood vessels and the heart, which can lead to heart attack and stroke, she says.
Phosphorus: The Expert Guidelines
Phosphorus recommendations depend on disease severity.
“We recommend limiting phosphorus intake, especially in people with advanced CKD,” says Mohan. A phosphorus-reduced diet typically allows 800 to 1,000 milligrams (mg) of the mineral per day, says Mok.
“Keep in mind that nutritional needs change depending on your stage of kidney disease and other health conditions you may have, so it’s important to work closely with your healthcare team and a registered dietitian to create a plan that’s right for you,” says Mok.
What Foods Have the Most Phosphorus?
How to Avoid Excess Potassium and Phosphorus
“In general, I advise my patients to focus on whole, minimally processed foods while prioritizing portion size, variety, and their own individual needs and preferences,” says Mok.
If your doctor and renal dietitian have recommended a potassium-restricted diet, Mok advises prioritizing lower-potassium fruits and vegetables like apples, berries, and green beans, and eating smaller portions. As for phosphorus, she says the most impactful thing you can do is reduce your intake of processed foods with phosphorus additives.
For people with CKD who feel overwhelmed or restricted by nutritional recommendations, Mok recommends meeting with a registered dietitian-nutritionist who can help you liberalize your food choices.
“By focusing on what you can have, we help you overcome the diet fatigue so often caused by the restrictive nature of medically prescribed diets, like a traditional kidney disease diet,” she says.
The Takeaway
- Dietary guidelines for potassium and phosphorus aren’t universal; a nephrologist and nutritionist can tell you your limits based on your stage of CKD, medications, and overall health.
- Experts generally recommend a daily limit of 2 to 3 g of potassium for those at risk, advising people with CKD to prioritize plant-based foods over more readily absorbed animal proteins and processed foods containing potassium additives.
- Since excessive phosphorus can leach calcium from bones into the bloodstream, people with CKD are often advised to limit their phosphorus intake to 800 to 1,000 mg per day, specifically avoiding processed foods that contain inorganic phosphorus additives.
- A plant-based diet focusing on whole, minimally processed foods is a primary strategy for managing one’s potassium and phosphorus levels, with an emphasis on choosing lower-potassium produce and reducing phosphorus additives.
Resources We Trust
- Mayo Clinic: Low-Phosphorus Diet: Helpful for Kidney Disease?
- National Kidney Foundation: Potassium in Your CKD Diet
- National Institute of Diabetes and Digestive and Kidney Diseases: Healthy Eating for Adults With Chronic Kidney Disease
- Cleveland Clinic: Diet for Chronic Kidney Disease
- American Kidney Fund: Kidney-Friendly Eating Plan
- Potassium. National Institutes of Health Office of Dietary Supplements. March 22, 2021.
- KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. International Society of Nephrology. April 2024.
- Hyperkalemia (High Potassium). Cleveland Clinic. May 11, 2023.
- Potassium Management in Kidney Disease. BCRenal. March 2023.
- Phosphorus. National Institutes of Health Office of Dietary Supplements. March 22, 2021.
- Phosphorus and Your CDK Diet. National Kidney Foundation. July 16, 2024.

Igor Kagan, MD
Medical Reviewer
Igor Kagan, MD, is an an assistant clinical professor at UCLA. He spends the majority of his time seeing patients in various settings, such as outpatient clinics, inpatient rounds, and dialysis units. He is also the associate program director for the General Nephrology Fellowship and teaches medical students, residents, and fellows. His clinical interests include general nephrology, chronic kidney disease, dialysis (home and in-center), hypertension, and glomerulonephritis, among others. He is also interested in electronic medical record optimization and services as a physician informaticist.
A native of Los Angeles, he graduated cum laude from the University of California in Los Angeles (UCLA) with a bachelor's in business and economics, and was inducted into the Phi Beta Kappa honor society. He then went to the Keck School of Medicine at the University of Southern California (USC) for his medical school education. He stayed at USC for his training and completed his internship and internal medicine residency at the historic Los Angeles County and USC General Hospital. Following his internal medicine residency, Kagan went across town to UCLA's David Geffen School of Medicine for his fellowship in nephrology and training at the UCLA Ronald Reagan Medical Center. After his fellowship he stayed on as faculty at UCLA Health.

Jessica Migala
Author
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.
She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).