Phosphorus is a mineral vital for good health — every cell in your body requires it for normal function, and it is a major component of your bones.

When kidneys are not working properly, they often cannot remove excess phosphorus from the bloodstream, allowing it to accumulate to unhealthy levels.

Health Risks of High Phosphorus

Excess phosphorus can cause calcium to leach from bones, potentially weakening them over time. High levels of both phosphorus and calcium together can form damaging deposits in soft tissues, including the heart, lungs, eyes, and blood vessels. This is why monitoring and controlling both minerals is essential for those with chronic kidney disease.

Recommended Intake

The recommended daily phosphorus amount for adults ranges between 800–1,200 mg. However, processed foods contain additives rich in phosphorus, and over the last 20 years, American consumption has increased by 10–15 percent.

Normal Phosphorus Levels

For non-dialysis patients, normal phosphorus ranges from 2.7–4.6 mg/dL. For dialysis patients, healthy levels are 3.0–5.5 mg/dL. Levels exceeding 5.5 are associated with increased calcifications and renal-related bone disease.

Dialysis and Phosphorus Control

While dialysis removes some phosphorus, you must also maintain proper levels between treatments through diet. A renal dietitian can provide guidance on foods to include and those to limit or avoid.

Reading Food Labels

Food labels do not legally require listing phosphorus content. Look for these ingredients indicating high phosphorus: pyrophosphate, polyphosphates, phosphoric acid, calcium phosphate, and sodium aluminum phosphate. Foods labeled "high in calcium" are typically high in phosphorus as well.

Phosphate Binders

Many kidney disease patients are prescribed phosphate binders, which absorb phosphorus in the stomach and gastrointestinal tract rather than allowing it to enter the bloodstream. The mineral is then eliminated through stool. These binders are typically taken before or after meals during digestion.

Foods High in Phosphorus to Avoid

  • Milk, milk-based drinks, yogurt, cheese, cottage cheese, pudding, and ice cream
  • Beef liver, chicken liver, and organ meats
  • Processed meats with phosphate additives
  • Canned fish with bones (sardines, salmon)
  • Dried beans and peas (lentils, split peas, lima beans, kidney beans, black beans, chickpeas)
  • Whole grain products and bran cereals
  • Nuts and seeds
  • Pizza
  • Cola drinks
  • Chocolate and cocoa drinks
  • Ale and beer

Smart Food Choices

Enjoy: Fresh or fresh-frozen meat, fish, and poultry without additives; white rice, pasta, grits, or couscous; green or wax beans; non-dairy creamers and soy milk; rice and corn cereals; white bread; butter and margarine; sorbet and gelatin; candy without chocolate or nuts.

Limit or Avoid: Processed meats; brown or wild rice; dried beans; milk products; whole grain cereals; whole grain breads; peanut butter; cheese products; cola drinks; ice cream; chocolate candy.