Phosphorus and early stage kidney disease

Phosphorus is a mineral found in every cell of the body. About 85% of phosphorus is in your teeth and bones. However, it also plays an important role in other parts of the body. The body uses phosphorus to: 

  • make bones and teeth strong
  • keep a normal pH balance
  • send oxygen to tissues
  • transform protein, fat and carbohydrates into energy
  • develop connective tissues and organs
  • help muscle movement
  • produce hormones
  • utilize B vitamins

Phosphorus is absorbed in the small intestine and stored in the bones. Healthy kidneys can filter excess phosphorus and other waste from your body. The more waste in your body, the harder your kidneys must work to remove it. When you have early stage kidney disease, your kidneys work harder to remove phosphorus. Recent studies show reducing phosphorus intake in earlier stages of CKD may help preserve kidney function and keep bones and heart healthy.

Phosphorus in the kidney diet

One of the ways to slow the progression of early stage kidney disease is by becoming aware of your current diet and setting goals to maintain a healthy lifestyle. Meat and dairy foods are rich in phosphorus, so the amount of these foods is controlled in the kidney diet. The average American diet has too many processed and convenience foods that contain added phosphorus. It is important to avoid phosphorus additives to control the amount of phosphorus in your diet. A renal dietitian will help you learn which foods should be avoided because of extra phosphorus.  

Long-term complications from too much phosphorus (hyperphosphatemia)

In the early stages of kidney disease, your life probably won’t need to change drastically. However, you may want to consider all you can do to prevent long-term complications. When kidneys are unable to remove excess phosphorus from the blood, it can build up. This is called hyperphosphatemia. This can be a problem for people with stage 4 and 5 kidney disease. 

High levels of phosphorus in the blood can cause:  

  • increased levels of PTH (parathyroid hormone), which over time can weaken bones and make them more likely to break
  • low blood calcium, which causes calcium to be taken from the bones
  • calcification or hardening of tissues and blood vessels, including the heart, arteries, joints, skin or lungs that can be painful and lead to serious health problems
  • bone pain
  • itching

Treatments for controlling phosphorus

The best way to reduce phosphorus in your blood is to maintain a low phosphorus kidney diet. As kidney disease progresses, treatments for high levels of phosphorus in the blood may include: 

  • Decreasing phosphorus in your diet.
  • Taking medicine called phosphorus binder that absorbs phosphorus in the gastrointestinal tract before it gets absorbed into your blood
  • Taking the active form of vitamin D, which helps balance calcium and phosphorus levels
  • Taking calcimimetic medicine to keep bones healthy and to potentially lower phosphorus
  • Dialysis treatments that cleanse the blood of excess waste.

Low phosphorus foods

Portion size plays a large role in healthy phosphorus levels. Consult your doctor or renal dietitian so that you can avoid high phosphorus foods. These foods are low in phosphorus:

Food Group

Low phosphorus


Certain nondairy creamers, cream cheese, rice milk (unenriched), sour cream, some brands of soy milk


Fresh or frozen meat, fish, poultry (unprocessed and not enhanced)


Cream of Rice, farina, corn or rice cereal, French/Italian/white bread, grits, pretzels, popcorn (unsalted), refined wheat cereals, white rice/pasta/couscous


All fruits are low in phosphorus


Most vegetables are low in phosphorus


Angel food cake, fondant, gelatin, gumdrops, hard candies, jelly beans, lemon cake, popsicles, sherbet, shortbread cookies, sorbet, sugar cookies, white or yellow cake


Cranberry juice, brewed iced tea and homemade lemonade, hot apple cider, lemon-lime/grape/strawberry soda, cream soda, root beer (some brands-check for phosphate additives)


Butter, honey, jam, jelly, margarine

High phosphorus foods

Food Group

High Phosphorus


Cheese, ice cream, milk, yogurt


Processed meats (bologna, hot dogs, sausage, turkey sausage), organ meats, sardines


Brown and wild rice, bran products (ex: cereals), biscuits, whole grain products (breads, pancakes, pasta, pizza)


Dried beans and peas


Beer, chocolate drinks, cola-type beverages


Chocolate, nuts, nut butters (peanut butter, almond butter), seeds


Phosphorus is a crucial mineral that helps your body function at its best. But too much of a good thing can be harmful. Moderation is the key to physical and mental wellness. Being proactive and learning about kidney disease is the best way to maintain good health. Early stage kidney disease can be managed by working with your doctor and renal dietitian, by making alterations to your diet and by maintaining a kidney-friendly lifestyle.

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05/18/2016 9:01 AM

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