Last updated: July 16, 2024
Medically reviewed by: NKF Patient Education Team
Phosphorus is a mineral found in your bones. Along with calcium, phosphorus is needed to build strong healthy 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. Over time this can lead to increased risk of heart attack, stroke or death. Phosphorus and calcium control are very important for your overall health.
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 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 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 drinks, 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 hexameta-phosphate
- Trisodium phosphate
- Sodium tripolyphosphate
- Tetrasodium pyrophosphate
Your kidney dietitian and doctor will help you with this. Below is a list of foods high in phosphorous and lower phosphorus alternatives to enjoy:
| High Phosphorus Food to Limit or Avoid | ||
|---|---|---|
| Beverages | beer/ale cocoa drinks made with milk canned iced teas bottled beverages with phosphate additives | chocolate drinks dark colas pepper type soda (Dr Pepper) |
| Lower phosphorus alternatives to enjoy: water, coffee, tea, rice milk (unenriched), apple juice, cranberry juice, grape juice, lemonade, ginger ale, lemon lime soda, orange soda, root beer | ||
| Dairy Products | cheese custard milk cream soups | ice cream pudding yogurt (Greek type acceptable) |
| Lower phosphorus alternatives to enjoy: rice milk, almond milk, cottage cheese, vegan cheese, sherbet, popsicles | ||
| Protein | oysters beef liver fish roe | sardines chicken liver organ meats |
| Lower phosphorus alternatives to enjoy: chicken, turkey, fish, beef, veal, eggs, lamb, pork | ||
| Other foods | chocolate candy caramels oat bran muffin | most processed/prepared foods/deli meats/hot dogs/bacon/sausage pizza brewer’s yeast chocolate caramel candies |
| Lower phosphorus alternatives to enjoy: apples, berries, grapes, carrot sticks, cucumber, rice cakes, unsalted pretzels, unsalted popcorn, unsalted crackers, pound cake, sugar cookies | ||
Looking for nutrition guidance? Contact a CKD dietitian in your area.
Kidney Health
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Join our kidney community for valuable tips and resources to support your kidney wellness journey.What else can I do to lower my phosphate?
Medicines
Phosphate binders: These medicines help “bind” the phosphorus in your food. This helps stop the phosphorus from getting absorbed into your body. These must be taken every time you eat, including meals and snacks. They are available in many forms, including tablets, capsules, chewable tablets, powders, and liquids. So, talk with your healthcare professional about the options to see which one(s) may best suit you.
Some phosphate binder examples include:
- calcium acetate (Phoslo, Phoslyra, Eliphos, Calphron)
- calcium carbonate (Tums)
- ferric citrate (Auryxia)
- lanthanum carbonate (Fosrenol)
- sevelamer (Renagel or Renvela)
- sucroferric oxyhydroxide (Velphoro)
The only available phosphate blocker is tenapanor (Xphozah). It is only approved for use in people who are also receiving dialysis treatments. (edited)
Dialysis
Dialysis can help remove some of the phosphorus from the blood, including both hemodialysis and peritoneal dialysis. For most people, dialysis does not remove enough phosphorus to reach the goal range. So, the primary focus of treatment is to limit how much phosphorus enters your blood in the first place.
On the other hand, people who receive hemodialysis treatments at home (either short daily or nocturnal [overnight]) have a lower risk of developing high phosphorus levels because they’re getting dialysis treatments more often. If you are on in-center hemodialysis, ask your healthcare professional if your dialysis settings can be adjusted to help lower your phosphorus.
