Between two dialysis sessions, your body has to cope with an invisible challenge: the potassium that builds up. In a healthy body, the kidneys continuously clear excess potassium into the urine. When you have end-stage chronic kidney failure, this filter has almost entirely disappeared. The potassium provided by your diet then stays in the blood, and its level can climb to dangerous thresholds.
This is what we call hyperkalaemia. In practical terms, an excess of potassium in the blood can disturb the heart's rhythm, cause palpitations and muscle weakness, and in severe cases trigger serious cardiac rhythm disorders. This is no small matter: it is one of the leading causes of emergencies in the dialysis patient.
The good news is that dialysis "resets" your potassium roughly every two days. The less good news is that it is the 36 to 72 hours between two sessions that will decide whether your levels stay safe or shoot up. And here, it is your plate that does the talking. Here are 7 potassium-rich foods to know and to keep in check in your everyday life.
Why potassium is risky for you
Potassium (K+) is a mineral found in almost every food. It plays a key role in the contraction of muscles, and the heart muscle in particular. In a healthy person, the kidneys continuously adjust its level. In advanced-stage chronic kidney disease, and even more so when you are on dialysis, this balance is no longer automatic.
When potassium rises too high, several signs may appear: palpitations, a feeling that the heart "skips a beat", weakness in the legs, tingling around the mouth or in the hands, unusual tiredness. In severe cases, the heart rhythm can become erratic. This is why your nephrologist monitors your blood potassium at every check-up.
The aim is not to alarm you or to deprive you. It is to understand that dialysis and your diet between two sessions are the two legs of the same balance. By adapting what you put on your plate, you keep control of your own safety, without giving up the pleasure of eating.
Food 1: dates (and dried fruit in general)
Dates contain around 650 mg of potassium per 100 g, which makes them one of the most concentrated foods commonly eaten in Algeria. And what is true of the date is also true of dried figs, dried apricots and raisins: drying removes the water but concentrates the minerals, potassium included.
This does not mean "banned for life". The idea is to keep the date as an occasional food, 1 to 2 units, not a daily portion. During Ramadan or Eid, where the date holds a special place in breaking the fast, talk it over with your team: it is often possible to alternate one date with another, less potassium-rich fruit, rather than eating five or six dates in a row.
As an alternative, you can turn to a fresh apple, a pear, a few strawberries or a mandarin in small amounts. These fresh fruits bring taste and freshness, with a far more moderate potassium load.
Food 2: the banana
The banana has long carried a reputation as "the potassium-rich fruit of athletes". For you, that is precisely what causes the problem: around 360 mg of potassium per 100 g, meaning a medium banana that can weigh 120 to 150 g.
The daily banana, out of habit, is not a good idea for the dialysis patient. Depending on your results and your team's advice, you can sometimes have a quarter or half occasionally, rather than a whole one every day.
To vary your fruit without overloading on K+, think of the apple, of pineapple in moderate amounts, or of watermelon, bearing in mind that it also provides a lot of water, which counts towards your interdialytic weight gain.
Food 3: the potato — unless "double-cooked"
The potato, the base of so many Algerian dishes, contains around 425 mg of potassium per 100 g. But it has an interesting feature: its potassium is largely soluble in water, which opens the door to a cooking trick approved in renal dietetics.
The technique: peel the potatoes, cut them into small cubes, soak them for 2 to 3 hours in a large amount of water, throw away that water, then cook them in plenty of water that you also throw away. This "double cooking" significantly reduces the potassium content of the final dish. Conversely, avoid steaming, cooking in foil parcels, or baking with the skin on, which retain all the potassium.
As an alternative, semolina-based couscous, white rice and pasta are starches that are more sparing in potassium, to be included in portions suited to your case.
Food 4: tomato purée and tomato sauces
This is one of the most common traps. A fresh tomato contains around 240 mg of potassium per 100 g. But tomato purée rises to around 1000 mg per 100 g, because all the water has been removed and the minerals are multiplied 4 to 5 times.
In practical terms, a large ladleful of purée in chorba, rechta or a tagine can push up the dish's potassium load without your realising it. The practical rule: no generous tablespoon of purée, rather 1 teaspoon at most depending on your case, and always discussed with your team.
To flavour your dishes without purée, rely on fresh tomatoes in small amounts, and above all on herbs: coriander, parsley, mint, a little garlic. The taste stays, the potassium drops.
Food 5: pulses (lentils, chickpeas, beans)
Pulses are very present in Algerian cooking. Dried, they show very high potassium contents — of the order of 870 to 1500 mg per 100 g depending on the variety (beans, lentils, chickpeas). Once soaked and cooked, these values fall: cooked pulses generally sit between 250 and 450 mg per 100 g, because some of the potassium diffuses into the soaking and cooking water. It is precisely for this reason that the preparation technique changes everything.
Soak your pulses for at least 12 hours, throw away the soaking water, then cook them in plenty of water that you also throw away before adding them to the dish. Then serve yourself small portions. For Friday couscous, for example, count on 5 or 6 chickpeas on your plate rather than a large ladleful.
For your protein intake, a small portion of white meat (chicken, turkey) or of fish, in line with your team's recommendations, can take over, consistent with your overall diet.
Food 6: dark chocolate and cocoa
This often comes as a surprise to patients: dark chocolate and pure cocoa are among the foods richest in potassium. Dark chocolate sits at around 700 mg per 100 g, and pure cocoa can climb beyond 1500 mg per 100 g.
The received idea that circulates — "dark chocolate is healthy, so I can eat it every day" — does not apply to your situation. The daily bar, even of 70 or 80% dark chocolate, is to be avoided. An occasional square remains possible if your results allow it, and only after talking it over with your team.
If you are looking for an alternative, white chocolate — richer in sugar but less concentrated in potassium — can do the trick in very small amounts. A plain biscuit, without chocolate or cocoa, is also a gentler option for your blood potassium.
Food 7: spinach, chard and other cooked green vegetables
Cooked spinach provides around 470 to 580 mg of potassium per 100 g, and chard is in the same range. Cooked, they shrink in volume but concentrate their minerals: a small portion that looks reasonable can in fact weigh heavily on the potassium side.
The double-cooking trick works here too: boil, throw away the water, cook again in fresh water. You can also favour these vegetables as a salad or raw occasionally, rather than in large cooked portions.
When it comes to better-tolerated vegetables, you can turn to courgette, cucumber, carrot in moderate amounts, cauliflower or green beans. Enough to put together colourful dishes without pushing up your blood potassium.
The summer trap in Algeria: watermelon, melon, apricot, fresh grapes
Summer in Sidi Bel Abbès and across Algeria more widely is the season when water-laden fruits turn up everywhere. Watermelon, melon, apricots, fresh grapes, plums: they are delicious, but they combine two constraints for you. A potassium load that is far from negligible, and a lot of water, which weighs on your weight gain between two sessions.
The rule: no free helping yourself to whole wedges. A small slice of watermelon, a few grapes, half an apricot — always in line with what your team has indicated for your water and potassium intake.
Recognising hyperkalaemia
Certain signs should put you on alert between two sessions: palpitations or a feeling that the heart "misses a beat", unusual muscle weakness, tingling around the mouth or in the limbs, marked and sudden tiredness. Not everyone has clear symptoms, which is why regular check-ups are essential.
If in doubt, do not stay alone at home trying to "see if it passes". Contact your haemodialysis centre, your nephrologist, or go to accident and emergency if the signs are marked. To better understand your illness as a whole, you can also consult our dedicated page to Understand kidney failure.
At Clinique ESSAADA, your dietary follow-up
At Clinique ESSAADA, your nephrologist adjusts your dialysis prescriptions and your dietary recommendations according to your regular results (blood potassium, phosphorus, urea, creatinine). No "standard" diet suits all dialysis patients: your tolerance depends on your residual kidney function, your dialysis and your clinical condition.
A meeting with a dietitian is particularly useful at the time of starting dialysis, and as soon as a result becomes unbalanced. It is an opportunity to review your habits, to identify the traps in your everyday cooking and to build a diet that is right for you — Ramadan, festivals and Friday meals included.
For any question about your diet or your dialysis, you can book a nephrology consultation, browse our FAQ for dialysis patients, or simply talk to the team at your next session. Adapting is not giving up: it is keeping control.
The potassium values given are reference ranges (CIQUAL/USDA). Your tolerated amounts depend on your results, your residual kidney function and your dialysis. Your nephrologist or dietitian sets your personalised targets.