Restricting your phosphorus intake is an important component of managing kidney disease. A healthy kidney will excrete excess phosphorus through urine. When your kidney function has declined, your body is unable to eliminate as much phosphorus. If your kidneys have completely shut down and you have started dialysis, then you only have excess phosphorus removed through your treatment. Decreasing your phosphorus intake will help prevent damage caused high blood levels of phosphorus. Most foods aside from certain fruits and vegetables contain phosphorus, so work with your health care team and a registered dietitian to help you follow a low phosphorus diet.
Phosphorus Roles
Phosphorus is a mineral that has many functions in your body, but mainly helps to keep calcium in your bones. High levels of phosphorus in your blood cause calcium loss from your bones making them brittle and easy to break. High phosphorus levels can lead to calcification of your arteries and tissues by leaving calcium deposits. A normal phosphorus level with kidney disease is 3.5 to 5.5 g/dL.
Dairy Products
Dairy products such as milk, cheese, cottage cheese, ice cream and yogurt are high sources of phosphorus. You should limit your dairy intake to only 4 oz. per day of milk, yogurt, or ice cream and 1 oz. of cheese, but not both. Foods that contain dairy like cream soups, cream sauces, pudding, pizza, lasagna, and macaroni and cheese for example should be avoided as they are high in phosphorus. Try rice milk or non dairy creamer on cereal or in cooking to reduce your phosphorus intake.
Protein
All meats including beef, pork, poultry, and fish, contain phosphorus, but you can still consume them as a protein source. Your protein needs are individualized, so talk to a dietitian about how much is safe for you. Processed meats like hot dogs, bologna, bacon, corned beef, salami, and certain deli-meats are high in phosphorus because of food additives used for preserving; you need to avoid these.
Fruits and Vegetables
Fruits are low in phosphorus aside from dried fruits. Vegetables are low in phosphorus except for corn, peas, dried beans, asparagus and mushrooms. Fruits and vegetables also contain potassium, another mineral that requires caution with kidney disease. Talk with your health care team about which fruits and vegetables are safe for you.
Grains and Carbohydrates
Normally, it is advisable to consume most of your carbohydrates from whole grain sources, but to reduce your phosphorus intake, you should avoid these foods. Whole grain sources include whole wheat breads, whole wheat pasta, brown and wild rice, and whole grain cereals like oatmeal, oat bran, or bran flakes. Refined grains including white bread, pasta, and rice, refined cereals like grits, cream of wheat, and cornflakes are low in phosphorus and safe to consume.
Other High Phosphorus Foods
Beverages that are high in phosphorus include dark sodas, fruit punch, hot chocolate or chocolate flavored beverages, and beer, which should be avoided. Keep coffee and tea to 8 oz per day since both contain phosphorus. Clear sodas, fruit flavored sodas, lemonade, and water are safe to drink on a low phosphorus diet. Chocolate, caramel, nuts, seeds and peanut butter are high in phosphorus and need to be avoided. Desserts or candy with these ingredients should also be limited. Choose angel food cake, crispy rice squares, lemon bars, sugar cookies, or hard candy instead.
Phosphorus Binders
Medications called phosphorus binders are available to assist you with lowering your blood phosphorus level. You should take a phosphorus binder every time you eat. The binder creates a gel in your stomach, which absorbs some phosphorus, so you do not. Your doctor will prescribe a binder appropriate to meet your needs. All foods have phosphorus, so even if you stay away from the high sources, your blood levels can still become elevated, which is the reason for using this medication.
References
- National Kidney Foundation: Phosphorus and Your CKD Diet
- "Nutrition and Diagnosis-Related Care"; Chronic and End Stage Renal Failure;Sylvia Escott-Stump; 2002
