How do you manage low phosphorus diet? - Kidney Disease

Kidney Disease

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How do you manage low phosphorus diet?

curiousmind2019 profile image
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For sodium, protein and potassium, those are easier to see from food nutrition info labels. How many of you are on a low-phosphorus diet? Do you comply to it regularly? How do you go about ensuring you are not consuming too much phosphorus?

My doc hasn't prescribed phosphorus binders yet (my P levels are high but not that high). Once on phosphorus binders, do you still have to worry about phosphorus?

This is more of a question for stage 4/5.

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curiousmind2019
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You are probably going to get a varied amount of responses to this so let me start. I have to watch my phosphorous carefully so I watch all of the foods I eat and don't take celebratory meals for good labs. I've included an article from NKF that explains more about it and provides a good breakdown of what to avoid. You should ask your Renal Dietitian about this and follow their advice. If I have any significant changes to my labs I get in touch with my RD and if I have to make changes then I do it. How diligent you want to be will be up to you. Personally, I don't want to have to deal with dialysis so I'm doing all I can to keep my kidneys healthy and functioning. Best of luck.

kidney.org/atoz/content/pho...

Bassetmommer profile image
BassetmommerNKF Ambassador

Hi Curiousmind,

I have to watch my P also. My levels are like yours, up but not extreme at all. I look up foods (Google) I am not sure of the content and then I track it on my meal plan. I have too have trouble often finding the P level so I Google directly "how much phosphorous does such and such have" I am still trying to find out what sugar free jello has.

After a while, you learn what to avoid or limit. I limit cheese (which I love) and dairy. And I do not eat things that have additives if I can help it. I also do not eat meat at all, rarely fish or seafood, and very little chicken anymore. Chicken and turkey are high in P. I do not eat lentils, beans or any form of nuts. I limit (sigh) chocolate to very little once in a while. I got out of the snack habit and the only munchie we have is popcorn, and that is only once a week lately on movie night. I make it from scratch, not microwave. That has very little P in it.

The thing about plant based phosphorous is that we only absorb half of the amount. Meat and dairy, we absorb the whole amount. It used to be they said to be careful with things like oats, but now, my dietician said it is OK. The fiber is good for me. I do however skip whole wheat, mostly because I am not crazy about it.

I am not on a binder, and my nephrologist and I talked about it. But I was on a potassium binder and it was awful tasting and it blocked me up like cement. I have a worse time with potassium because I eat a ton of greens. I probably will be forced at some point to take it again because....there is so little left to eat that doesn't have some health affect and I love my lettuce.

curiousmind2019 profile image
curiousmind2019 in reply to Bassetmommer

Hi Bassetmommer..

I google too! But how do you know a food item is too much? Over 100mg, 200mg,... ? It's there a good rule of thumb you go by?

The part about cheese is tough, I love food with cheese on it (lasagna, pizza, creamy cheesy pasta). In addition to the cheese, there's also the issue with wheat (and maybe tomatoes for potassium).

Eating plant-based food seems difficult with potassium restrictions. So far, I have only really found that there are 4 vegetables I can eat that's somewhat low in phosphorus and potassium: cabbage, cauliflower, lettuce and eggplant. Are there other good alternatives?

Now that I'm on PD, they want me on a high protein diet, it's hard to get enough protein when just before PD, I was on low protein diet and started to not eat so much meat. Beans are out due to phosphorus, so now I am trying egg whites but I can only eat so much egg whites.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to curiousmind2019

Yes, it is so very tricky. To answer the first question, I find that by logging my food I can keep a tab on my intake for the day. So if I am high in either K or P, my next meal is limited.

I would suggest you check with a renal dietician, but I think the value of phosphorous in beans is half absorbed because it is plant. However, lentils and chick peas are high in potassium and that is not halved.

I eat exactly what you eat but I also eat broccoli. I leech it for about an hour or more in warm water and then boil it in fresh water. It has protein in it and I love it. I use a lot of cauliflower.... roasted, grilled, and boiled. When I eat 3 eggs, I add one whole to two only egg whites.

I spent a bit of time yesterday going through the Davita recipe collection for salads and I did find a couple of them. They list all the values including phosphorous. The thing with Davita recipes is that they aren't always so good for you. For example, the Ranch dressing they have has more than twice the calories than my bottled version. Although the bottle brand has salt and some additives, I don't eat enough of it to compensate for the double calories in their version. Also, looking at the portions, the nutritional values seem wonderful until you see it is only a 1/2 cup of what ever. 1/2 of cup is nothing when it comes to my main foods. Now wonder it looks healthy until you see it is one bite :)

in reply to Bassetmommer

When we were regularly visiting Houston, TX, my nephrologist there prescribed a prescription phosphorous binder I was able to obtain free. I forget the name, only that it was new on the market. It caused constipation, and so I dropped out after 9-10 months.

Two things help me: (1) the DaVita "Kidney Smart" seminar (which I've taken 3 times now), and (2) my at-home diet is routine. I'm CKD 4 (eGFR is 27-29). I should be even more disciplined by keeping a day-by-day log of what I eat and drink x mg of protein, sodium, potassium and phosphorous. I'd like to consult with a renal dietician, but we have none in Richmond, VA, where my wife and I live. Can a log be as simple as creating a form for 8-1/2 by 11 paper, then entering the values for food eaten each day?

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to

HI,

Davita has an place where you can keep the log and it already has quite a library of food so you do not have to google as much. I use it and then I stop for a while because it becomes quite a pain. Then I start to see weight come back on and I go back to it. I used Myffitnesspal before but the information in their library is very inaccurate and does not have potassium and phosphorous information.

orangecity41 profile image
orangecity41NKF Ambassador

I use the Davita diet tracker to plan and track my food. The diet am on is restricted on phosphorus, potassium and sodium.

TwangGuru01 profile image
TwangGuru01

I highly recommend Susan Zogheib's two Renal Diet Plan & Cookbook. The two volumes that I have include several charts with Phosphorus content of foods.

HSV21 profile image
HSV21

Her Renal Diet Cookbook is helpful, but is it written more for Stage 3?

RhenDutchess123 profile image
RhenDutchess123

It would be nice to have a wearable device that told you your Phosphorus Level anytime you wanted to check....Like Dexacom that tells Diabetics their glucose level

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