Phosphate Intake in Chronic Kidney Disease (Predialysis and Dialysis)

Next to calcium, phosphate is the second abundant essential mineral in your body. Phosphate is found in every cell of your body, but more than 80 % are present in your bones and teeth.

Phosphate is an important element for many essential processes in your body:

  • Formation of bones and teeth 
  • Utilization of fat, carbohydrate and protein for maintenance, growth and repair of cells 
  • Energy production 
  • Utilization of many B-vitamins

Why should you watch your phosphate intake if you suffer from CKD?

High phosphate levels may be detected in your blood because your kidneys are not able to remove phosphate in a sufficient way. Also in haemodialysis or peritoneal dialysis blood phosphate levels may be high because these treatments often do not remove sufficient amounts of phosphate. High blood phosphate levels may cause itching and may result in losing calcium from your bones (like in osteoporosis). Additionally high phosphate levels may promote the calcification of arteries, and thus increase your risk to develop cardiovascular diseases.

High phosphate levels contribute to the development of bone disease and cardiovascular disease in CKD.

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Many protein-rich foods contain phosphate in abundance, and its consumption is lower as protein in your diet is restricted. In this way, high phosphate levels in your blood can be corrected as well. Furthermore, very high phosphate levels are usually treated with medicine that prevents phosphate from being absorbed in the digestive tract. These medicines are called phosphate binders. They bind phosphor while they are in your gut. In this form the phosphate is eliminated by your body with your faeces and will not enter your blood.

What are the main sources of phosphate in your diet?

The following foods contain considerable amounts of phosphate:

  • Milk, yogurt, cheese 
  • Meat (especial liver and other organ meats) 
  • Fish (canned fish and fish products) 
  • Whole grain/Cereals 
  • Dried beans and peas 
  • Nuts/almonds 
  • Chocolate/cocoa 
  • Cola and beer

Recommended Intake

Content last updated
  1. NKF K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis 2000; 35 (Suppl 2): S1-S140. (last visited 20.04.2010)
  2. Cano N, Fiaccadori E, Tesinsky P et al.: ESPEN Guidelines on Enteral Nutrition: Adult Renal Failure. Clin Nutr 2006; 25: 295–310.
  3. Fouque D, Vennegoor M, ter Wee P et al.: EBPG Guideline on Nutrition. Nephrol Dial Transplant 2007; 22 (Suppl 2): ii45–ii87 (last visited 20.04.2010)