Managing Phosphorus in a CKD Diet

Managing Phosphorus in a CKD Diet

Introduction

Phosphorus is a mineral that is found in your bones. According to kidney.org, a normal phosphorus level is between 2.5 and 4.5 mg/dL. Make sure to ask your doctor or dietitian what your last phosphorus level was and keep track of it. Your kidneys are responsible for removing extra phosphorus in your blood. People with CKD or other kidney complications may have trouble removing phosphorus, which can lead to high levels of phosphorus in your body. Having high phosphorus levels can be dangerous to your body, and contribute to pulling calcium out of your bones, making them weak. High phosphorus and calcium levels can lead to dangerous calcium deposits in blood vessels, lungs, eyes, and heart. Controlling phosphorus and calcium in your diet is very important for your overall health.

Phosphorus Additives Found in Food

Phosphorus additives (inorganic phosphorus) can be found in foods like microwaved or ready to eat dinners, canned or bottled beverages, fast food, processed meats and other processed foods. Unlike organic phosphorus, phosphorus that is added to foods is completely absorbed into the body, and must be watched carefully if you’re dealing with a low phosphorus CKD diet. Look for “PHOS” on nutrition labels to find phosphorus additives.

Phosphorus additives found in foods include:

  • Dicalcium phosphate
  • Disodium phosphate
  • Monosodium phosphate
  • Phosphoric acid
  • Sodium hexameta-phosphate
  • Trisodium phosphate
  • Sodium tripolyphosphate
  • Tetrasodium pyrophosphate

High-Phosphorus Foods

Beverages

  • beer/ale
  • chocolate drinks
  • cocoa
  • dark colas
  • drinks made with milk
  • canned iced teas
  • pepper type soda (Dr Pepper)
  • bottled beverages with phosphate additives
Dairy Products

  • cheese
  • liquid nondairy creamer
  • custard
  • ice cream
  • milk
  • pudding
  • cream soups
  • yogurt (Greek type acceptable)
Protein

  • oysters
  • sardines
  • beef liver
  • chicken liver
  • fish roe
  • organ meats
Other

  • chocolate candy
  • caramels
  • oat bran muffin
  • most processed/prepared foods
  • pizza
  • brewer’s yeast

Hidden Phosphorus

  • Like in any diet, fresh foods are the best.
  • Beware of phosphorus added to packaged foods, microwaved foods, frozen dinners, spreadable cheeses and certain snacks.
  • Always check food labels for “PHOS” to find hidden phosphorus
  • Instead of chicken nuggets → fresh chicken breast
  • Instead of cola → ginger ale

Dealing With Dairy

  • Milk and dairy products are high in phosphorus.
  • Try dairy substitutes like rice milk that are lower in phosphorus
  • Instead of milk → unfortified rice milk
  • Instead of ice cream → sorbet

Snacking on a Low Phosphorus Diet

  • Snacking is ok if you make the right choices and use moderation
  • Snacks are also a good way to increase calories
  • Instead of nuts or mixes with nuts > unsalted popcorn or pretzels
  • Instead of chocolate cookies > vanilla wafers

Getting Protein From Vegetables

  • Phosphorus found in animal foods is absorbed more easily than phosphorus found in plant foods.
  • Make sure to ask your dietitian how to use vegetable protein in your diet
  • Try new recipes with things like stir-fried tofu, pasta, rice or beans.

Dining Out on a Low Phosphorus Diet

  • Just stay away from fast foods. They are loaded with phosphorus
  • Always choose restaurants that make food from scratch with whole foods and fresh ingredients.
  • Always eat with moderation. If the portion size is too large, eat half and bring the rest home.
  • Instead of cheese burger > hamburger with lettuce and onion
  • Instead of cheese enchilada > beef or chicken taco with lettuce and onion

Cheating on a Low Phosphorus Diet

  • If your blood  phosphorus level is in a good range, ask your dietitian if it’s ok to have foods that are high in phosphorus by having small portions.
  • Instead of 1 cup of ice-cream > 1/2 cup if ice-cream
  • Instead of 2 slices of pizza > 1 slice of pizza

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