September 17, 2026
Article By: NKF Staff
Managing phosphorus can be hard for people on dialysis. It usually means changing diet, taking medicines, and tracking lab results. It can also lead to questions about kidney transplant, with some people wondering if having high phosphorus can affect their chance of getting a transplant.
To learn more, the National Kidney Foundation (NKF) asked people on dialysis about how they managed phosphorus and whether phosphorus had been discussed during the kidney transplant process.
Table of Contents
- Why Is Phosphorus Important?
- Why Did NKF Ask People About Phosphorus?
- Managing Phosphorus Can Be Hard
- Many People Were Unsure If Phosphorus Affected Their Transplant Journey
- Was Phosphorus Discussed During the Transplant Process?
- Does High Phosphorus Prevent Someone From Getting a Kidney Transplant?
- What Did People Say Would Help?
- What Can We Learn From This Survey?
Key Takeaways
Key Takeaways
Phosphorus management is a daily challenge: 44% found meeting their phosphorus goal difficult, and 55% said it affected daily life.
Phosphorus and transplant access remain unclear: More than 1 in 4 respondents were unsure whether phosphorus had affected their transplant journey.
Patients want clearer support: Respondents called for clearer phosphorus goals, more dietitian support, and practical guidance on food and medications.
Why Is Phosphorus Important?
Phosphorus is a mineral the body needs to help keep bones strong and make energy. But too much phosphorus can lead to problems.
Healthy kidneys remove extra phosphorus from the blood, but damaged kidneys may not be able to. This can cause phosphorus to build up. Over time, high phosphorus can harm bones and blood vessels, increasing the risk of heart and blood vessel problems.
Treatment for high phosphorus may include diet changes and medicines called phosphate binders or blockers. But managing phosphorus is not always easy.
Why Did NKF Ask People About Phosphorus?
A blood test can show if someone's phosphorus level is high. But it does not tell the full story.
For example, a lab test cannot show if someone is having trouble:
- Paying for foods that fit their diet
- Taking or swallowing their medicine
- Reading and understanding food labels
- Finding foods they enjoy
- Managing medicine side effects
- Understanding their phosphorus goal
- Knowing whether phosphorus could affect their transplant evaluation
NKF wanted to better understand these challenges by asking people on dialysis directly about:
- Managing high phosphorus
- Phosphorus-lowering medicines
- Diet changes
- How phosphorus affects daily life
- Information about phosphorus and kidney transplant
Learning about these experiences helps NKF identify where people need better information and support.
Managing Phosphorus Can Be Hard
Many people who took the survey had been told that their phosphorus was too high.
- 79% had been told at some point that their phosphorus was too high.
- 56% said their phosphorus had been above their goal at least a few times in the past six months.
- Nearly 70% had been asked to change their diet or start or change a medicine because of high phosphorus.
Keeping phosphorus within a target range can be difficult.
In the survey:
- 44% said meeting their phosphorus goal was somewhat, very, or extremely hard.
- 53% said following a low-phosphorus diet was at least somewhat difficult.
- 55% said managing phosphorus affected their daily life at least moderately.
These numbers show that phosphorus management is more than a lab result. It can affect what people eat, the medicines they take, and their daily lives.
Many People Were Unsure If Phosphorus Affected Their Transplant Journey
The survey also asked people if high phosphorus had affected their progress toward a kidney transplant.
The answers were mixed:
- 19% believed high phosphorus had affected their progress.
- 43% believed it had not.
- 26% were unsure.
- 12% had not started the transplant process.
That means more than 1 in 4 people were not sure if phosphorus had affected their transplant journey.
For someone already dealing with dialysis and a transplant evaluation, not knowing what a lab result means for the transplant journey can add stress.
Was Phosphorus Discussed During the Transplant Process?
About 68% of people who took the survey were either being evaluated for a kidney transplant or already on the transplant waitlist.
But only 49% said someone on their dialysis care team had talked with them about phosphorus control as part of the transplant waitlist process.
Those who did speak about phosphorus with their healthcare team reported different answers.
Some were told that phosphorus was just one of many things considered during the transplant process. Others were told that high phosphorus could delay their progress or that their phosphorus needed to be controlled before they could be added to the waitlist.
These different experiences can leave people unsure about what phosphorus means for their own transplant journey.
Watch videos by real patients to learn more about kidney transplantation.
Does High Phosphorus Prevent Someone From Getting a Kidney Transplant?
Not necessarily.
There are many factors that determine whether or not someone is eligible for a transplant. And every kidney transplant center has different eligibility criteria.
NKF’s survey does not show that having high phosphorus prevents someone from being placed on the kidney transplant waitlist or from receiving a kidney transplant. The survey does show that phosphorus may be discussed as part of the transplant evaluation. Importantly, you do not need a referral to be evaluated for transplant eligibility. Learn more about how to find and contact a transplant center.
Looking for support from someone who understands? Get matched with a trained NKF Peer mentor.
What Did People Say Would Help?
The survey gave people on dialysis a chance to describe what would make managing phosphorus easier.
They asked for:
- Clear information about their phosphorus goal
- More time with a kidney dietitian
- Help learning how to read food labels
- Help with grocery shopping
- Recipes and food lists
- Food advice that takes cultural preferences into account
Most importantly, people want to know why phosphorus matters, not just which foods to avoid.
Find kidney-friendly recipes and nutrition information in NKF's Nutrition Hub.
What Can We Learn From This Survey?
For people on dialysis, managing phosphorus is about more than a number on a lab report. It is a lifestyle. The survey points to a need for clearer communication–people need to know what their phosphorus goal is, how to manage it, and whether it has any role in their transplant evaluation.
NKF will continue to listen to people with kidney disease and use their experiences to help improve kidney health information and support.
