Phosphorus and Your CKD Diet

What is phosphorus?

Phosphorus is a mineral found in your bones. Along with calcium, phosphorus is needed for building healthy strong bones, as well as keeping other parts of your body healthy.

Why is phosphorus important to you?

Normal working kidneys can remove extra phosphorus in your blood. When you have Chronic Kidney Disease (CKD) your kidneys cannot remove phosphorus very well. High phosphorus levels can cause damage to your body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak. High phosphorus and calcium levels also lead to dangerous calcium deposits in blood vessels, lungs, eyes, and heart. Phosphorus and calcium control is very important for your overall health.

What is a safe blood level of phosphorus?

A normal phosphorus level is 2.5 to 4.5 mg/dL. Ask your doctor or dietitian what your last phosphorus level was and write it down to help keep track of it. 

Will dialysis help with phosphorus control?

Yes. Dialysis can remove some phosphorus from your blood. It is important for you to understand how to limit build-up of phosphorus between your dialysis treatments.

How can I control my phosphorus level?

You can keep you phosphorus level normal by understanding your diet and medications for phosphorus control. Phosphorus can be found naturally in foods (organic phosphorus) and is naturally found in protein-rich foods such as meats, poultry, fish, nuts, beans and dairy products.  Phosphorus found in animal foods is absorbed more easily than phosphorus found in plant foods. 

Phosphorus that has been added to a food in the form of an additive or preservative (inorganic phosphorus) is found in foods such as fast foods, ready to eat foods, canned and bottled beverages, enhanced meats, and most processed foods. Phosphorus from food additives is completely absorbed.  Avoiding phosphorus additives can lower your intake of phosphorus. Phosphorus additives are found on the list of ingredients on the nutrition facts label. Look for “PHOS” to find phosphorus additives in the food.

Phosphorus additives found in foods include:     

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

 

Below is a list of foods high in phosphorous

 

HIGH PHOSPHORUS FOOD TO LIMIT OR AVOID

 

Beverages
ale
beer
  chocolate drinks cocoa
  drinks made with milk
canned iced teas
dark colas
     
Dairy Products cheese cottage cheese
  custard ice cream
  milk/non-dairy creamer pudding
  cream soups yogurt
     
Protein carp crayfish
  beef liver chicken liver
  fish roe organ meats
  oysters sardines
     
Vegetables: Dried Beans and Peas    
   baked beans black beans
  chickpeas/garbanzo beans lentils
  kidney beans northern beans
  limas split peas
   pork ’ n beans  
   soybeans  
     
Other foods bran cereals brewer’s yeast
  caramels nuts
  seeds wheat germ
  whole grain products  

What are medications for phosphorus control?

Your doctor may order a medicine called a phosphate binder for you to take with meals and snacks. This medicine will help control the amount of phosphorus your body absorbs from the foods you eat. There are many different kinds of phosphate binders. Pills, chewable tablets, powders, and liquids are available. Some types also contain calcium, while others do not. You should only take the phosphate binder that is ordered by your doctor or dietitian.

What do I do if my phosphorus level is too high?

When your phosphorus level is too high, think about your diet and substitute lower phosphorus foods for a while. Talk to your dietitian and doctor about making changes in your diet and ask about your phosphate binder prescription.

 

HIGH PHOSPHORUS FOODS
INSTEAD OF
LOW PHOSPHORUS FOODS
TRY
  Phosphorus (mg)       Phosphorus (mg)
8 ounce milk 230   8-ounce Almond Breeze Milk  34
 
8-ounce cream soup made with milk
275
  8-ounce cream soup made with water 90
1 ounce American Cheese 145   1 tbsp cream cheese 15
½ cup ice cream 80   ½ cup sherbet  38
12-ounce can cola 55   12-ounce can of Ginger Ale or lemon soda 3
1 biscuit egg, sausage sandwich (fast food) 562   4" bagel 89
1 1/2-ounce chocolate bar 125   1 1/2-ounce hard candy, fruit flavors or jelly beans 3
8-ounce cocoa made with milk 255   8-ounce cocoa made with water 89
1 ½ ounce chocolate bar 125   1 ½-ounce hard candy, fruit flavors or jelly beans 3
         
         

More than 20 million Americans—one in nine adults—have chronic kidney disease and most don't even know it. More than 20 million others are at increased risk. The National Kidney Foundation, a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases and increase the availability of all organs for transplantation. Through its 50 affiliates nationwide, the foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations.

The National Kidney Foundation would like to thank the
Council on Renal Nutrition for the development of this fact sheet.