Your kidney-friendly food plan: Managing phosphorus

As you navigate your diagnosis of kidney disease, your doctor will likely have advice for you in the way of food and nutrition. You likely have been told that your kidneys are not filtering your blood as well as they should and this may affect your body's mineral balance. So what does this have to do with nutrition?

There are several nutrients that you should keep in check when managing kidney disease. In particular, phosphorus is a mineral that is important for many body functions. It is found in your bones and helps your body build cells and helps energy transfers throughout the cells. When your kidneys are working normally, they remove extra phosphorus in your blood. But when your kidneys are not working well, your body is not able to get rid of the extra phosphorus. Having too much phosphorus can affect the balance of other minerals in your blood. A specific balance between the amount of calcium and the amount of phosphorus is vital. If the extra phosphorus cannot be released from your body, it will build up in your blood. This buildup causes your body to pull calcium from your bones in an effort to regain that balance. If it pulls too much calcium, your bones may become brittle and weak.

You may be taking phosphorus binders, medicines prescribed by your doctor to help your body get rid of extra phosphorus. Taking binders as prescribed is important. There are also some foods you should avoid, or limit, to avoid phosphorus-related problems.

Lower-phosphorus alternatives to choose:

• Fresh fruits and vegetables
• Rice milk, unenriched
• Breads
• Pasta
• Rice
• Fish
• Corn and rice cereals
• Soda without phosphate additives
• Home-brewed ice tea

High-phosphorus foods to avoid or limit:

• Dairy foods
• Beans
• Lentils
• Nuts
• Bran cereals
• Oatmeal
• Colas and other drinks with phosphate additives
• Some bottled ice tea

Some foods may also contain phosphate additives that could add up to 1000 mg/day of phosphorus to your intake. Since your doctor has likely asked you to limit your phosphorous to 800-1000mg/day, you should be aware of foods with phosphate additives. Some foods that contain these additives are:

• Processed meats
• Instant puddings and sauces
• Spreadable cheeses
• Beverage products

It is important to read the label of every item you pick up in the grocery store and look for ingredients with "phosphate" or "phos" in their names, such as phosphoric acid, sodium aluminum phosphate, pyrophosphate, polyphosphates and calcium phosphate. When you find them, you should avoid or limit those foods.

A dietitian experienced in managing a kidney-friendly food plan can also help. The American Nutrition and Dietetics website can help you find one.

You can, in partnership with your health care team, help control the effects of your kidney disease. A healthy, balanced food and fluid plan, with careful attention to phosphorus intake, can help you do that.

References

Nelms, M., Sucher, K., Lacey, K., & Long Roth, S. (2011). Diseases of the Renal System. In Nutrition Therapy & Pathophysiology (2nd ed., p. 841). Belmont, CA: Wadsworth.

Gropper, S., Smith, J., & Groff, J. (2009). Macrominerals. In Advanced Nutrition and Human Metabolism (5th ed., p. 600). Belmont CA: Wadsworth.