Your kidneys function by filtering waste products from your blood so that they can be excreted in your urine. But if your kidney function is impaired due to an underlying disorder such as diabetes, waste products can build up to toxic levels in your blood. A dialysis machine acts as a mechanical kidney, working to clean your blood before returning it to your body in a continuous loop. Although it's life-saving, dialysis is not as efficient as healthy kidneys, and relying on it can lead to abnormal levels of certain substances, such as calcium, in your blood, the Mayo Clinic says.
The Calcium/Phosphorus Relationship
Dialysis can't remove all levels of certain substances from your blood, resulting in undesirably high levels. Serum phosphate is one common nutrient disturbance related to dialysis treatment. Common in many protein-rich foods, phosphorus -- particularly in high levels -- leads to low serum calcium levels. And low blood calcium can lead to several adverse health conditions, such as osteoporosis, according to the American Association of Kidney Patients. So the key to maintaining a healthy serum calcium level while on dialysis is a two-step process. You must first learn to avoid phosphorus-rich foods, and consume more calcium-rich foods. If this doesn't result in a therapeutic outcome, your doctor may prescribe specific medications.
High-phosphorus Foods
No matter how effective your dialysis regimen, you're still likely going to have higher blood phosphorus levels than someone with healthy kidneys. In varying amounts, phosphorus is in almost every food you eat. However, knowing what foods tend to contain more phosphorus helps guide your dietary choices. High-protein foods are generally going to contain more phosphorous than other foods. Moderate the amount of meat you eat and stay away from organ meats in particular. Phosphorus-rich vegetables to avoid include beans, peas, corn, pumpkin, sweet potatoes, broccoli, asparagus, spinach and mushrooms. Unlike most other diets, a low-phosphorus diet does not allow for whole-grain cereals, bread and rice. Stick to the refined alternatives for these choices. Most dairy products are loaded with phosphorus, so avoid products made with milk -- including hard cheese, soups, ice cream, dairy creamers and toppings, yogurt and pudding. Cola and chocolate products also contain too much phosphorus, the Mayo Clinic says.
Food-product manufacturers will also add ingredients containing phosphorus to their products, usually as a thickener or color preservative. When you check food labels, avoid products containing these ingredients, including monopotassium phospate, phosphoric acid, tricalcium phosphate, disodium phosphate and calcium phosphate.
High-calcium Low-phosphorus Foods
Because maintaining a healthy serum calcium level is your concern, make choices that also contain higher amounts of calcium. High-calcium, low-phosphorus foods include calcium-fortified juices, such as apple and orange juice; kale that is either raw or cooked; turnip greens; and Chinese cabbage. Calcium-fortified white breads and cereals are also acceptable choices, barring any phosphorus-containing additives, as are white-flour tortillas, the National Institutes of Health says. There are also a few dairy products that are safe to incorporate in moderate amounts, including cream cheese, nondairy toppings, butter, sherbet, ricotta cheese and tub margarine, MedlinePlus says.
Medication Intervention
It's difficult to maintain a low-phosphorus diet that is well-rounded enough to provide adequate amounts of any essential nutrient, let alone calcium. Your doctor will likely prescribe both a vitamin D and calcium supplement, as well as a medication called a phosphate binder. A phosphate binder acts as a sponge, binding with the phosphorus in your blood to create a compound your body cannot absorb. You excrete this compound in your stool. In combination with a lower-phosphorus diet, a phosphate binder allows you to enjoy foods from all food groups, This provides full nutritional benefit from a well-rounded selection of meats, dairy products, grains and fruits and vegetables -- especially those that contain high levels of calcium, according to the American Association of Kidney Patients.
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