Phosphorus and Calcium
Phosphorus is a mineral used by your body to make bones and teeth, and to use and store energy.
Healthy kidneys get rid of phosphorus in the urine. In kidney failure, the phosphorus level can become too high. Phosphorus is not removed very well in dialysis because it is a big molecule. If it is not treated, you will have the problems caused by a high phosphorus level.
When the phosphorus level in you blood is too high, calcium will be pulled from the bones. This can form a calcium-phosphorus substance in the blood. When this settles in the muscles and body organs, it is called a, “calcium deposit”. It is painful when it is in your feet and harmful in the blood vessels or body organs (which includes the heart).
Each month your phosphorus level will be checked. The level of phosphorus in your blood will help determine if you are eating too many high phosphorus foods and if you need to be on medication to help control the phosphorus level in your blood.
The desired level of phosphorus is 3.5 – 5.5
To keep phosphorus at the correct level, you may need to take a phosphate binder (i.e. Tums, Phoslo, or Renagel) with ALL of your meals and snacks. This will bind much of the phosphorus in foods you eat, and will not allow it to enter your blood. The excess phosphorus will leave your body by way of the digestive system. Each month your calcium level will be checked. With kidney failure the calcium levels tend to run high and supplements are not recommended unless your doctor prescribes it.
The desired level of calcium is 8.3 – 9.5
Bone disease develops over time and occurs faster if your PO4 and Calcium are high. You may not notice any problems right away, but be aware of the following signs:
- Itching
- Pain in joints and bones
- Abnormal blood values for phosphorus or calcium
- Easily broken bones
- Bony calcium deposits (painless hard or soft lumps) under your skin, in your heart and/or your lungs
There are several things you can do to prevent this from happening:
- Limit the high phosphorus food in you diet
- Take your phosphate binders as prescribed with meals and snacks
- Get enough dialysis – do not cut short your treatment time
Foods which are high in phosphorus include:
- Milk and Dairy products (limit to 1 cup/day)
- Cheese
- Meat, fish, poultry, eggs (You need to eat 6-8 oz of these per day for protein!!)
- Nuts
- Dried beans
- Some vegetables
- Whole grains
- Chocolate
- Beer and Dark Cola drinks
Printable Version (PDF)
| Low Phosphorus Foods – (80mg or less) | |
|
Beverages:
Alcohol (hard), 3 oz.- 10mg Breads and Cereals:
Bread, white, 1 slice - 20mg Dairy Products:
Butter, Marg., 1 Tbsp - 2mg Fruits: All Fruits, 1/2 c. - 40mg Meats, Fish, and Poultry:
Bacon, 1 strip - 20mg |
Vegetables: Any not listed under medium and Snacks and Desserts:
Cake, 1 slice - 65mg Miscellaneous:
Jams, Jellies, 1 Tbsp. - 2mg Dairy Substitutes:
Meadow Fresh, 1/2 c. - 60mg |
| Medium Potassium Foods – (80 - 199mg) | |
|
Beverages:
Beer, 12 oz. - 110mg Breads and Cereals:
Cheerios, 1 c. - 115mg Dairy Products:
Cheddar cheese, 1 oz.- 135mg |
Meats, Fish, and Poultry (cooked): Remember, you need 6-8 oz.per day!!!
Chicken, 1 oz.- 70mg Vegetables:
Lentils, split peas, 1/2 c. - 130mg Snacks and Desserts:
Custard, 1/2 c. - 150mg |
| High Potassium Foods – (200mg or more) | |
|
Breads and Cereals:
All Bran, 1/3 c. - 265mg 100% bran 3/4 c. - 400mg Dairy Products:
Buttermilk, 1 c. - 220mg |
Miscellaneous:
Pizza, 1 slice (med) - 200mg |