Phosphorus and Chronic Kidney Disease

Phosphorus is a "mineral", a basic electrolyte found in our nutrition, and kidney is one of the basic organs that regulates phosphorus in our body. Renal failure may even lead to an increase in phosphorus in the blood (hyperphosphatemia), even at an early stage.
 
  • What is phosphorus good for?
  • Along with calcium they are vital for the metabolism and health of our bones. It contributes to the metabolism of carbohydrates, proteins and fats and is involved in the production of energy for the body’s cells.
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  • I have CKD. Should I reduce phosphorus intake?
  • Yes, depending on your kidney failure level, it may be necessary to limit phosphorus on the daily diet. Typically, your diet may include a phosphorus restriction of 800-1,000 mg daily (whereas the usual daily consumption is twice as high in healthy individuals). Your phosphorus needs may vary depending on your kidney function and your nephrologistwill advise you accordingly.
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  • I am on dialysis therapy.Should I reduce the phosphorus consumption?
  • Yes! Consuming foods high in phosphorus will increase electrolyte levels in blood. Dialysis cannot remove all this phosphorus. As phosphorus is increased, calcium is reduced in the blood. As a result, this will have an impact on the "health" of your bones, making them brittle. Except for bones, excess phosphorus will cause problems in your blood vessels, heart, skin and muscles.
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  • How can I limit phosphorus in my diet?
  • Phosphorus is found in many foods. As a natural element of foods (in high protein foods such as meat, fish, dairy products), but also as an additive (a preservative, stabilizer and flavor enhancer in pre-cooked foods and fast food meals). The second is also the worst because it is completely absorbed by our digestive system. The best way to reduce it is to reduce the consumption of foods rich in phosphorus and especially foods that phosphorus has been added as a preservative.
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  • Which foods are rich in phosphorus?
  • Sugar, olive oil, fruits, vegetables, and eggwhite are foods that contain a minimum amount of phosphorus. Generally, these foods can be consumed freely, as far as phosphorus is concerned. There are foods higher in phosphorus (cereals, pasta, bread, rice, cornflakes, legumes), but in a form poorly absorbable by phosphorus. In this way, they can be consumed in 2 or up to 3 servings per day. Moreover, animal source foods contain more phosphorus than the previous groups (lamb, hare, trout, solea, milk, yoghurt). Especially milk and yogurt, although they contain a large amount of phosphorus, a single serving a day of them does not increase the amount of phosphorus in the blood. In addition, a portion of turkey, offal, shrimp, squid and salmon per week should be consumed by CKD patients, while foods such as soft drinks, processed foods and processed cheese should be avoided.
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  • How is phosphorus indicated on food labels?
  • It is named as 'phosphorus' but also foods labeled with the word 'phospho-' indicate that they contain phosphorus in various forms. "Hidden" phosphorus in food is also in the form of preservatives - enhancers with codes E340 to E458, which should be avoided.
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  • What is the use of phosphate binder?
  • Phosphate binders act as a sponge and absorb - bind the phosphorus found in the food we have consumed. There are different kinds of phosphate bindersyour nephrologist prescribes them ,and they should be taken during meals. In this way, the amount of phosphorus that goes into the blood is limited. They should be taken with foodor around meal times according to your nephrologist's instructions, but also during a "snack" that you decided to have apart from your meals. 
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  • Mesogeios Dialysis Centers Group Scientific Team 
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  • Bibliography 
  • 1.Nutrition for Chronic Kidney Disease in Adults, The National Institute of Diabetes and Digestive and kidney Diseases Health Information Center, 2017
  • 2.Eating A Pre-Dialysis Kidney Diet - Sodium, Potassium, Phosphorus and Fluids: A Kidney Disease Solution, Anderson CA, Nguyen HA, Rifkin DE. Nutrition Interventions in Chronic Kidney Disease. Med Clin North Am. 2016 Nov;100(6):1265-1283. doi: 10.1016/j.mcna.2016.06.008. Epub 2016 Sep 13. Review. PubMed PMID: 27745594.
  • 3.Obi Y, Qader H, Kovesdy CP, Kalantar-Zadeh K. Latest consensus and update on protein-energy wasting in chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2015 May;18(3):254-62. doi: 10.1097/MCO.0000000000000171. Review. PubMed
  • 4.Carrero JJ, Cozzolino M. Nutritional therapy, phosphate control and renal protection. Nephron Clin Pract. 2014;126(1):1-7. doi: 10.1159/000357679. Epub 2014 Jan 11. Review.
  • 5.Nadkarni GN, Uribarri J. Phosphorus and the kidney: What is known and what is needed. Adv Nutr. 2014 Jan 1;5(1):98-103. doi: 10.3945/an.113.004655. Review.
  • 6.Malberti F. Hyperphosphataemia: treatment options. Drugs. 2013 May;73(7):673-88. doi: 10.1007/s40265-013-0054-y. Review.
  • 7.Filipowicz R, Beddhu S. Optimal nutrition for predialysis chronic kidney disease. Adv Chronic Kidney Dis. 2013 Mar;20(2):175-80.
  • 8.Gutiérrez OM. Sodium- and phosphorus-based food additives: persistent but surmountable hurdles in the management of nutrition in chronic kidney disease. Adv Chronic Kidney Dis. 2013 Mar;20(2):150-6. doi: 10.1053/j.ackd.2012.10.008. Review.
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