Do you love pizza? Really, I think there are very few people in the world who don’t. But, you may be wondering how you can fit pizza into a renal diet.
One mineral that often raises concern for individuals with kidney issues is potassium. While potassium is essential for maintaining muscle and nerve function, those on dialysis need to be particularly mindful of their potassium intake.
In this blog post, we’ll uncover the sources of potassium in pizza ingredients, discuss its impact on kidney health, and offer practical tips and recommended products to help you savor a slice of pizza without compromising your health.
Table of Contents
Potassium and Kidney Function
Potassium is an essential mineral that plays a crucial role in various functions of the body, including proper muscle and nerve function, maintaining heart rhythm, and regulating blood pressure.
The kidneys are responsible for maintaining proper potassium balance in the body. Kidney disease can impair this function, potentially leading to the accumulation of excess potassium in the bloodstream, a condition known as hyperkalemia.
Because of this, you usually need to limit your potassium intake if you are on dialysis. The type of dialysis you are doing in addition to the frequency and time on dialysis will factor in to your potassium needs. If you’re on PD or home hemodialysis, dialyzing more frequently, you can usually tolerate a more liberal potassium intake in comparison to in-center hemodialysis.
It’s important that you work closely with your healthcare provider and dietitian to manage your potassium intake and keep your potassium levels within a safe and healthy range.
Potassium In Pizza
The potassium content of pizza can be very high since several pizza ingredients and toppings are rich sources of potassium.
The main sources of potassium in pizza ingredients are primarily the tomato sauce, meat toppings, and certain vegetable toppings. In addition, the cheese and the crust add on to the total potassium load.
A high potassium food is usually considered to be 200 mg or more per serving. Some foods are naturally lower in potassium. However, if you eat a larger serving of a low potassium food it can easily turn into a high potassium food, so portion size matters!
Sodium And Phosphorus In Pizza
In addition to being high in potassium, pizza is also very high in both phosphorus and sodium. A triple whammy! This is especially the case if you are getting pizza at a restaurant or fast food take-out, but also holds true for frozen pizzas.
The cheese, crust and meat toppings all contribute to the phosphorus load. The high sodium content comes from the tomato sauce, cheese, crust, and meat toppings.
Cheese and processed meat are also a significant source of saturated fat. The American Heart Association recommends limiting saturated fat to about 5% to 6% of your total calories. If you need 2,000 calories a day, this would be no more than 120 calories coming from saturated fat per day (or 13g/day).
By now, I’m sure I have put you in a state of deep depression. But, don’t fret! I’ll be getting to the better options soon because you can make pizza fit into a renal diet. You just have to be savvy about it.
The following table looks at a couple popular take-out options for pizza. The approximate potassium, sodium and phosphorus content is only for 1 slice. Most people usually have more than one slice, so you can see if you had multiple slices how quickly these numbers would add up!
The following table looks at four frozen pizza options. Note that the potassium and sodium amounts are for 1/3 of the pizza or 2 slices. So, you tend to get a little more out of frozen pizzas in comparison to take-out. Unfortunately, the phosphorus amount was not listed.
While California Pizza Kitchen’s four cheese pizza looks like it contains the least potassium, I wouldn’t call it your best option. This pizza will definitely contain more phosphorus as well as saturated fat.
If I were to pick, I would probably choose Amy’s Margherita pizza. You can enjoy your two slices and add a side salad with olive oil, balsamic vinegar and pepper and enjoy without guilt!
Make Your Own Lower Potassium Pizza
Now, if you really wanted to do it right I would recommend making your own pizza at home. That way you can control the ingredients and make a much lower potassium, phosphorus and sodium pizza and have fun doing it together as a family. It’s really pretty easy!
The following are dialysis friendly ingredient recommendations:
First off, let’s talk sauce. Since typical tomato-based pizza sauce is naturally high in potassium, a good swap is using more of a red pepper sauce. It still contains potassium but cuts the amount down a bit.
You can make your own, but I found this pretty cool option that you can buy online. Stonewall Kitchen Fire Roasted Arrabbiata Pizza Sauce which contains 134 mg potassium and 160 mg sodium per 1/4 cup serving.
I used to recommend using a pesto sauce instead of traditional pizza sauce. But, once I started looking at pesto sauces I realized that even though they tended to be lower in potassium they were really high in sodium. Most pesto sauces contain over 400 mg sodium for just a 1/4 cup.
The best bet if you love pesto (which I do) would be to make your own.
Now we get to the foundation. I found a couple of good options that were reasonable in potassium and sodium yet required little effort to assemble.
If you shop at Safeway, you can find Organics Personal Pizza Crust Thin & Crispy which contains 90 mg potassium and 55 mg sodium per entire pizza crust.
If you’re super fancy and shop at Whole Foods, their 365 Rustic White Pizza Crusts* contains 60 mg potassium and 40 mg sodium. Not bad!
Low Potassium Toppings
Here are a few lower potassium options for pizza toppings:
- Onions (red, yellow, green, shallot, leek)
- Bell Peppers (capsicum)
- Banana peppers
Just remember that all of these toppings still contain potassium, but if you control the amount they add a lot of flavor and fun to your pizza.
Lower Potassium & Phosphorus Cheeses
Pizza and cheese just go together. At least that is what we are used to. I am used to having it without cheese, but if you are looking for a lower potassium and phosphorus option here are your best bets (per 1 oz serving):
- Ricotta (~2 Tbsp)
- Feta (1/4 cup crumbled)
- Goat (~2 Tbsp)
- Mozzarella (~1/4 cup or 3 mozzerella balls)
As you can see, pizza contains several ingredients which contribute to its potassium content. Tomato sauce, cheese, meat toppings, crust, and certain vegetables are key sources. Not only can pizza be high in potassium but it tends to be high in phosphorus and sodium as well.
Does this mean pizza can’t fit into a renal diet? I think not! As long as you’re aware of your ingredients and control the amount you eat then you can definitely make a more dialysis-friendly version.
Opt for lower potassium alternatives and modify ingredients. Choosing the right crust, sauce, and toppings can help you manage your potassium intake. Then you can enjoy your pizza while keeping your potassium levels in check.
For more on potassium check out the blog “Low Potassium Dessert Ideas.”