Low-phosphorus diet: Best for kidney disease?

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Low-phosphorus diet: Best for kidney disease?

Question

Why is a low-phosphorus diet useful in managing kidney disease? What foods contain phosphorus?

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Answer

The kidneys help regulate the level of phosphorus in your blood. If your kidney function is impaired, eventually you'll likely have elevated phosphorus levels (hyperphosphatemia). In turn, the elevated phosphorus decreases the level of calcium in your blood, which can lead to bone disease.

Often, 800 to 1,000 milligrams (mg) of phosphorus a day is the limit for someone who has kidney disease. Most healthy adults may eat double this amount.

Nearly every food contains some phosphorus, so you can't eliminate all phosphorus from your diet. Generally foods high in protein (some meats, dairy products, beans, legumes, nuts and seeds) are higher in phosphorus. Therefore, unless you're receiving kidney dialysis, you'll be asked to eat smaller quantities of them. Whole grains also are higher in phosphorus, so choose refined ones.

The following list may help you identify which foods to select.

Instead of these higher phosphorus foods:Choose these lower phosphorus foods:
Milk, pudding or yogurt (from animals and from many soy varieties) Rice milk (unfortified) or nondairy creamer
Hard cheeses or Neufchatel cheese Cream cheese or cottage cheese
Ice cream or frozen yogurt Sherbet or frozen fruit pops
Soups made with higher phosphorus ingredients (milk, peas, beans, lentils) Soups made with lower phosphorus ingredients (broth- or water-based with other lower phosphorus ingredients)
Whole grains, including whole-grain breads, crackers, cereal, rice and pasta Refined grains, including white bread, crackers, cereals, rice and pasta
Quick breads, biscuits, cornbread, muffins, pancakes or waffles Refined (white) dinner rolls, bagels, English muffins or croissants
Peas (fresh green, split, black-eyed), beans (black, garbanzo, lima, kidney, navy, pinto) or lentils Green peas (canned, frozen), green beans or wax beans
Starchy vegetables: corn, parsnips, pumpkin or sweet potato Starchy vegetables: potato, rutabaga or winter squash
Other vegetables: artichokes, asparagus, broccoli, mushrooms, peapods (cooked) or spinach Other vegetables: cabbage, beets, carrots, celery, cucumbers, eggplant, lettuce, peppers, onions, tomatoes or summer squash
Organ meats, walleye, pollock or sardines Beef, pork, lamb, poultry or other fish
Fats: cream (including fat-free, half and half), sesame butter (tahini) or sour cream Fats: butter, margarine, mayonnaise, salad dressing, shortening or vegetable oils
Chocolate Hard candy or gumdrops
Cola soft drinks Lemon-lime soda, ginger ale or root beer

This chart is only a partial listing of suggestions for foods lower in phosphorus. Your needs may vary depending on your kidney function.

Manufacturers may use phosphorus-containing ingredients when processing foods to thicken, improve taste or prevent discoloration. Look at the ingredients list to see if phosphorus has been added and choose a similar food item that doesn't have such additives. Look for any ingredient that contains "phos" in the term. Dozens of additives contain phosphorus. Here are some examples:

  • Calcium phosphate
  • Disodium phosphate
  • Phosphoric acid
  • Tricalcium phosphate
  • Monopotassium phosphate
  • Pyrophosphate polyphosphates

Food manufacturers aren't required to list the amount of phosphorus in foods on food labels. For help creating a meal plan that meets your needs, consult a registered dietitian. He or she can help you make sure that you're getting adequate nutrition while following the dietary guidelines provided by your doctor.

Because it's difficult to lower phosphorus in your diet, your doctor may recommend a phosphate binder medication that can help control the amount of phosphorus your body absorbs from foods you eat. Your doctor may also recommend calcium and other supplements depending on your nutritional needs. Also, be sure to avoid medications and supplements that contain phosphorus.

Last Updated: 2010-08-07
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