Puzzled about phosphorus?
Has your doctor told you that you need to reduce your phosphate levels and have you been on the internet researching how to do this? Have you found the information confusing and conflicting? Then read on!
What is Phosphorus?
Often referred to as phosphate*, phosphorus is a mineral found in all of our cells and is essential to many metabolic processes. Just like calcium, phosphorus is needed to build strong healthy bones.
Why is phosphorus important to people with kidney disease?
The kidney is the major organ in regulating phosphate balance. Normal working kidneys can remove extra phosphorus in your blood. When you have chronic kidney disease (CKD), your kidneys cannot remove this excess phosphorus. High phosphorus levels can cause damage to your body.
So what can happen?
This extra phosphorus will pull calcium out of your bones, making them weak. High phosphorus and calcium levels also lead to dangerous calcium deposits in various parts of the body including blood vessels, lungs, eyes, and heart.
How can I control my phosphorus level?
High phosphate levels can be controlled with either diet and or medications called phosphate binders.
Thankfully the nutritional advice we give people with kidney disease regarding phosphate is changing. Traditionally clinicians use to look at the phosphate value of a food and advise people to avoid the high ones and eat the low ones. It sounds simple but with this system it just cuts out more foods from what might be an already strict renal diet.
Much research has been done into phosphate. Not all food is created equally in terms of phosphate and therefore does not influence blood phosphate results the same way. Different factors influence the phosphate count including whether the food is organic or inorganic (natural or processed), whether the product is an animal or plant source protein, its phosphate to protein ratio, how the food is digested by our gastrointestinal system and whether the product contains particular additives.
Unfortunately phosphate is not required by law to be on a nutrition label but the ingredient list will help determine if there is added phosphates in a particular product. A low phosphate diet should be done in consultation with your nephrologist and a dietitian with experience in renal disease.
Kirilee is a specialist dietitian with experience in renal disease. She sees clients on the North Shore and Northern Beaches of Sydney. Get in touch today if you would like to work together on your nutrition goals.
*phosphorus and phosphate have been used interchangeably throughout this blog
References
Gandy, J (ed), 2007, Manual of Dietetic Practice, 4th Edition, Wiley-Blackwell, Oxford.
Kamyar et al. Understanding Sources of Dietary Phosphorus in the Treatment of Patients with Chronic kidney Disease. Clin J Am Soc Nephrol 2010,5:519-530
NICE (2013) Hyperphosphataemia in chronic kidney disease: Management of hyperphosphataemia in patients with stage 4 or 5 CKD. Clinical guideline 157
Snelson M et al. Stirring the Pot: Can Dietary Modification Alleviate the Burden of CKD?. Nutrients. 2017 Mar 11;9(3). pii: E265.
