Phosphorus

What is phosphorus?

Phosphorus, like potassium, is found in many foods and is important for many different functions in your body. The phosphorus that you eat is in the form of phosphates.

When you are on dialysis you will need to limit how much phosphorus (phosphates) you eat. You might need to start limiting phosphorus before starting dialysis. Ask your doctor or dietitian if you need to start limiting phosphorus

Phosphorus does a lot of important things for your body including:

  • Builds bones and teeth (along with calcium)
  • Provides energy
  • Is required for DNA

Many foods use phosphorus, as additives help keep the food fresher. Our body absorbs 100% of the added phosphorus. These can be found in any bagged, boxed, canned, or bottled foods. You should avoid or limit foods with these additives. Look on the ingredient list to know if the item has added phosphorus.

What are the types of phosphorus?

Phosphorus comes in two forms, natural and added

Natural phosphorus is found in your food (e.g. chicken, beef, milk, beans, and grains)

  • Protein is high in phosphorus
  • Fruits and vegetables are low in phosphorus

Added phosphorus is added to preserve food; It is commonly found in:

  • Lunchmeat
  • Hot dogs
  • Pancake/biscuit mixes
  • Ranch dressing
  • Fast food
  • Frozen foods
  • Tortillas
  • Colas, canned/bottled tea, and powdered lemonade
  • Many other types of packaged foods

Your body absorbs natural phosphorus differently depending on the type of food. It absorbs:

  • 40% of grains
  • 60% of meats, beans, and nuts
  • 80% of dairy
  • 100% of added phosphorus.

Added phosphorus:

Because the body absorbs 100% of added phosphorus, it is very important to read the label on food items that come in a box, bag, or jar.

This is also why it is always important to take your phosphate binders (medicines used to reduce the absorption of phosphates) if prescribed by your doctor, every time you eat.

Phosphorus is difficult to find when looking on the food label. Go to the ingredient list to find added phosphorus and keep a list of the brands without added phosphorus to make shopping easier the next time.

A quick way to spot added phosphorus is to look for phos in the ingredient list. Some examples include:

  • Phosphoric Acid
  • Pyrophosphate
  • Polyphosphate
  • Hexametaphosphate
  • Dicalcium Phosphate
  • Ferric Phosphate
  • Sodium Phosphate
  • Monocalcium Phosphate
  • Aluminum Phosphate
  • Sodium Polyphosphate
  • Sodium Tripolyphosphate
  • Sodium Polyphosphate
  • Sodium Tripolyphosphate
  • Trisodium Phosphate
  • Tetrasodium Phosphate

Phosphates are the form of phosphorus found in your body. Phosphates are a large molecule made of phosphorus and oxygen. The large size of this molecule makes it hard to remove during dialysis. This is why it is important to take your phosphorus binders every time you eat, or drink a powdered, canned, or bottled beverage.

High phosphorus (hyperphosphatemia)

Having too much phosphorus in your body can cause harm.

Too much phosphorus can:

  • Pull calcium from your bones making your bones weak and brittle.
  • Raise your blood pressure due to narrowed blood vessels from the calcium and phosphorus crystals.
  • Form and deposit a calcium and phosphorus structure in your veins and organs. Over time this can create bonelike crystals.
  • Cause calciphylaxis – painful sores on the skin that can lead to infection.

For more information about high phosphorus and bone disease click here.

Manage phosphorus

Follow these tips to keep your phosphorus level in check:

  • Keep a list of your favorite foods that do not have added phosphorus
    • Check these products at least once a year, just in case the ingredients change
  • Check nutrition labels for added phos
    • The closer to the top of the ingredient list, the higher the amount of phosphorus in the product.
    • The more types of added phosphorus in one product, the more phosphorus it has.
  • Always carry your phosphate binders with you, especially when you are going out to eat.
    • Try to keep them in places where you eat: kitchen table, couch, dining room, etc.
  • Take your phosphate binders 5 or 10 minutes before you eat
  • Choose grilled rather than breaded or fried foods (the breading has added phosphorus)
  • Cook at home
  • Talk with your dietitian if your phosphorus unexpectedly rises 

Low phosphorus (Hypophosphatemia)

Having a low level of phosphorus is uncommon but can happen. If your phosphorus level is low it might be because you do not have a good appetite and you are not eating enough, or you may be taking too many binders. Talk to your doctor or dietitian about how to keep your phosphorus at the right level.

Oftentimes there are no symptoms of low phosphorus.

If you have severely low phosphorus (phosphorus less than 1mg/dL), you could experience:

  • Respiratory failure
  • Heart failure
  • Seizures
  • Coma

Low phosphorus recipes with Chef Joel Schaefer

The strict diet that chronic kidney disease patients must follow includes foods that are low in phosphorous. Chef Joel Schaefer is an expert in cooking healthy foods that meet special dietary needs.

Tips on managing your phosphorus

To learn more about managing your phosphorus in real-life situations, like shopping in a grocery store or eating in a restaurant, watch the following videos.

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