Thursday, 06 February 2014 07:46

Low-phosphorus diet: Best for kidney disease?

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Why is a low-phosphorus diet useful in managing kidney disease? What foods contain phosphorus?

Calcium and phosphorus, which are minerals, help build strong bones. Healthy kidneys help regulate the level of phosphorus in your blood by removing extra phosphorus. If your kidneys aren't working properly, eventually you'll probably have high phosphorus levels in your blood (hyperphosphatemia). Too much phosphorus decreases the level of calcium in your blood, which can lead to bone disease.

Your phosphorus needs may vary, depending on your kidney function. For adults with kidney disease, generally 800 to 1,000 milligrams (mg) of phosphorus a day is the limit. Many healthy adults eat almost double this amount.

Nearly every food contains some phosphorus. As a general rule, foods high in protein are also high in phosphorus. If you have an earlier stage of kidney disease, you'll likely be advised to limit your intake of phosphorus and protein. A reduced-protein diet helps limit the amount of waste that builds up in your blood.

If you have late stage kidney disease and you're on dialysis, the picture changes a bit. Dialysis removes protein (in the form of waste) from your blood, so your protein needs increase — but you'll still need to choose lower phosphorus foods. A registered dietitian can help you choose protein-rich foods that are lower in phosphorus.

Below is a partial listing of foods lower in phosphorus to help you identify substitutes for higher phosphorus foods. Although a food or drink may be low in phosphorus, you still need to watch portion sizes and limit the number of servings you eat or drink each day.

Instead of these higher phosphorus foods:

Choose these lower phosphorus foods:

Milk, pudding or yogurt (from animals and   from many soy varieties)

Rice milk (unfortified), nondairy creamer   (if it doesn't have terms in the ingredients list that contain the letters   "phos")

Hard cheeses, ricotta or cottage cheese,   fat-free cream cheese

Regular and low-fat cream cheese

Ice cream or frozen yogurt

Sherbet or frozen fruit pops

Soups made with higher phosphorus   ingredients (milk, dried peas, beans, lentils)

Soups made with lower phosphorus ingredients   (broth- or water-based with other lower phosphorus ingredients)

Whole grains, including whole-grain breads,   crackers, cereal, rice and pasta

Refined grains, including white bread,   crackers, cereals, rice and pasta

Quick breads, biscuits, cornbread, muffins,   pancakes or waffles

Homemade refined (white) dinner rolls,   bagels or English muffins

Dried peas (split, black-eyed), beans   (black, garbanzo, lima, kidney, navy, pinto) or lentils

Green peas (canned, frozen), green beans or   wax beans

Organ meats, walleye, pollock or sardines

Lean beef, pork, lamb, poultry or other fish

Nuts and seeds

Popcorn

Peanut butter and other nut butters

Jam, jelly or honey

Chocolate, including chocolate drinks

Carob (chocolate-flavored) candy, hard candy   or gumdrops

Colas and pepper-type sodas, flavored   waters, bottled teas (if a term in the ingredients list contains the letters   "phos")

Lemon-lime soda, ginger ale or root beer,   plain water

Manufacturers may add phosphorus when processing foods to thicken, improve taste or prevent discoloration. Check the ingredients to see if phosphorus has been added. If so, choose a similar food item that doesn't have such additives.

Dozens of additives contain phosphorus. Look for any ingredient that contains "phos" in the term. Here are some examples:

  • Calcium phosphate
  • Disodium phosphate
  • Phosphoric acid
  • Tricalcium phosphate
  • Monopotassium phosphate
  • Pyrophosphate polyphosphates

Food manufacturers often don't list the amount of phosphorus on food labels. In addition, fast foods and convenience foods have potentially large amounts of phosphorus, which may be used as a preservative, among other things.

For help creating a meal plan that meets your needs, consult a registered dietitian. A dietitian can help make sure that you get enough nutrition while following your doctor's medical recommendations. Confirm all recommended food substitutes with your dietitian.

Because it's difficult to lower phosphorus in your diet, your doctor may recommend a phosphate binder medication to help control the amount of phosphorus your body absorbs from foods. Your doctor may also recommend calcium and other supplements, depending on your nutritional needs. Ask your pharmacist to check your medications and supplements for phosphorus.

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