phosphate : Good Evening, a little question... - Kidney Disease

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phosphate

Miss-guineapig profile image
32 Replies

Good Evening, a little question. I was reading an article about white and whole grain bread. I believe with CKD it is advised to eat white bread due to lower phosphates. The article said that this is not always the case, as although whole grain has more phosphates we only absorb 20-50% of the phosphates compared to 100% of phosphates absorbed in white bread. Can anyone clarify this.

Thank you and hope folks are doing ok x

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Miss-guineapig profile image
Miss-guineapig
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32 Replies
Mich1949 profile image
Mich1949

Very good question! I hope someone who can answer that will do so.

Pisces101 profile image
Pisces101

Hope some one with knowledge about this answers.. I found this Irish site which says more about bread types than many others: irishkidneydiet.ie/2016/07/... The post is six years old though, and that causes some concern. Another paper from 2010 says absorption rate is 10-30 for both whole grain and white bread, but with more phosphorous in whole grain: escholarship.org/content/qt... DaVita - from 2019 - says there has been a change in what is advised and whole grain is no longer to be avoided completely: blogs.davita.com/kidney-die....

There’s constantly smth new..

Miss-guineapig profile image
Miss-guineapig in reply toPisces101

Thank you Pisces, will have a wee read x

Bassetmommer profile image
BassetmommerNKF Ambassador

Plant based phosphorous contains phytates and that is what prevents the absorption of all the phosphorous in plant base items such as oats. Be careful here because you said phosphate which can be an additive. Store bought bread is processed and so I am not sure the principal of the phosphorous not being complete absorbed is the same with all the additives. Whole grains that are not processed are great for you as long as you check to make sure what else is in the product. Phosphorous additives are everywhere.

Dicalcium phosphate.

Disodium phosphate.

Monosodium phosphate.

Phosphoric acid.

Sodium hexameta-phosphate.

Trisodium phosphate.

Sodium tripolyphosphate.

Tetrasodium pyrophosphate.

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

Here is a clearer picture of ingredients, I’ve not a clue if it’s good for state 3a or not, any advice please.

Ingredients of bread
Miss-guineapig profile image
Miss-guineapig

Thank you so much Bassett. Wow! No wonder I get confused, it’s so difficult. A wee question which I hope you can advise Bassett and don’t mind sharing. I won’t speak with my lawyer, I promise 😂. It just takes so much reading and research for a newbie but what make and type of bread would you eat if you were stage 3a? x

orangecity41 profile image
orangecity41NKF Ambassador in reply toMiss-guineapig

In my CKD diet I am restricted to 5-6 servings of 1 oz, per day, in the bread/starch group. Best to check with a dietitian on one's CKD level.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toMiss-guineapig

Orange is correct about checking with a dietician. For me, I was not really aware when I was stage 3. But when I did learn about all this, I stopped store bought bread UNLESS the store was a bakery, and the label was very clear as to what is in it. Less is more. Bread that hangs around for more than a couple of days has additives. I also learned to make my own bread and did that a lot. Takes time, but oh boy is it good out of the oven.

It used to be the thinking that whole grains were not good for CKD. That is completely false. Whole grains are great for you. Things like oatmeal and bran have more health benefits than issues. The fiber is what is good for you. White bread, nah... unless it is mine, is not so good.

I also found a low carb, low everything wrap that actually does not taste like cardboard and I use them a lot instead of bread. Not sure what is available where you are, but they can be a good alternative. But watch the sodium in them.

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

Thanks so much Basset, will definately look into this x

CuriousCKD profile image
CuriousCKD in reply toBassetmommer

Will you share the brand of wrap you’re using, in place of bread? I generally eat a slice of a specific, store bought sourdough bread, and I weigh it out, so that it fits into my daily calorie, sodium, potassium count. However, I would love to free up some calories, so that I could eat more of something else. If I made my own bread all hope would be lost as I don’t have a lot of control, when it comes down to freshly baked bread. I’m salivating, as I write! 🤤😑

Miss-guineapig profile image
Miss-guineapig in reply toCuriousCKD

Sent photos of bread I use below, great for toast too, but not a clue if it’s CKD ‘friendly’ but the best I can find xx

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toCuriousCKD

this is what I use and I do not eat them all the time. And yes, there are additives, but very limited.

Low calorie wraps
CuriousCKD profile image
CuriousCKD in reply toBassetmommer

Thanks very much! I will look for them.

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

They don’t look Scottish but I’ll goggle and have a look, thank you

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toCuriousCKD

see above

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

Wee request the same as Curious please. I live in Scotland so may not get it here. For now I use Danish bread x

Basic ingredients but not sure if suitable for everyone with CKD
Miss-guineapig profile image
Miss-guineapig in reply toMiss-guineapig

Is this bread ok for stage 3a CKD

Danish white bread 62 calories a slice, low sugar
Bassetmommer profile image
BassetmommerNKF Ambassador in reply toMiss-guineapig

there are additives in this. Calcium propionate is an organic salt that is used as a food additive. It helps preserve foods, mainly baked goods, by interfering with the growth and reproduction of microorganisms, such as molds, bacteria, and fungi. And there are a bunch of numbers that I have no idea what they are...

However..... one or two slices of this is a good choice for a bread. Low salt, some protein which is good when eating carbs, and the carbs are reasonable.

Unless you are eating the whole loaf....it looks like a good choice.

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

Thank you so much, appreciate your opinion. I’ll stick with this for now. On another issue, Feeling chuffed today as my creatinine has went down a little bit. Every little helps x

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toMiss-guineapig

Stick with what you know

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toMiss-guineapig

Believe it or not, they are on Amazon, Costly that way.

Miss-guineapig profile image
Miss-guineapig in reply toBassetmommer

😄 just goes to show what you can get on line…but I like a bargain x

Miss-guineapig profile image
Miss-guineapig

Thank you Orangecity, In Scotland you don’t see a dietician till you’re stage 4/5 as far as I know. Struggling to find one but will keep looking. x

barbara55109 profile image
barbara55109

Is you phosphorus even high? Are you on a binder? My phosphorus is slightly high. I take a binder and don't worry about dietary phosphorus other than dark pop. I don't drink dark pop at home. But after have to have diet coke at restaurants. My individual body needs potassium! I have no colon and dehydration caused my stage 4 CKD. Eat to your labs. If your phosphorus isn't high you don't need to focus on it.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply tobarbara55109

Hi Barb, Can you tell me how high your phosphorous is? And you are not on dialysis either, correct?

barbara55109 profile image
barbara55109 in reply toBassetmommer

At my last nephrology lab in August 2023 my phosphorus was 4.5. The normal range is 2.3 to 4.7. Looking at my trend page the highest it ever was is 5.5. Cutting out the coke zero at home and taking a binder when I drink diet pop in restaurants appears to be enough to keep me normal. Nope, not on dialysis yet. I do point out, over and over, I'm not "normal." I lost my colon 31 years ago and my CKD is primarily from dehydration. I am T2D, but it has always been in control. The standard CKD diet advice doesn't apply to me. I NEED salt and potassium. I'm not the only outliner though, so I try to remind everyone to eat to their labs, not the standard CKD diet advice. When I first got diagnosed I panicked, read everything I could get my hands on. My anxiety levels were so high I was suicidal. Once I learned about my labs, my condition, and a year of therapy - my anxiety levels became more manageable.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply tobarbara55109

I am glad things are going better and well for you. I do not consume anything to drink other than water and sometimes hibicus tea. But even stopped that for now. Even clear soda has additives in it and diet is even worse.

RhenDutchess123 profile image
RhenDutchess123 in reply tobarbara55109

Its the dyes they put in Cola that cause most the harm. .Even tho your phosphorus levels stay in range doesnt mean you are not damaging your GI track, which includes your Esophagus

Miss-guineapig profile image
Miss-guineapig

Hi Barbara, I don’t know if phosphorus is high , I am just wanting to do the best I can at stage 3a to give my kidneys the best chance in the future. I am quite new to all this so reading all I can and certainly focusing on all research as best I can. Probably overload I know but I want to do the best I can as early as I can. For now, I am cared for by my GP and will get an annual check which is normal protocol for Scotland. Only med I’m on is an ace inhibitor, but it’s a reduced dose at the moment as my creatinine had increased , so watch this space. Wishing you well Barbara x

barbara55109 profile image
barbara55109 in reply toMiss-guineapig

You really need labs to know what you need. I too freaked, read everything, and had terrible, life threatening anxiety when I first got diagnosed. Take a deep breath. The standard low salt, low potassium, low phosphorus, diet advice does not apply to everyone. Jumping on those 3 without labs can be dangerous. Potassium and phosphorus labs are standard for CKD folks. Check to make sure your GP didn't already get them. If not, request them. In terms of what to do to slow down your CKD it is dependent on the cause. Do you know the cause? If high blood pressure you first course of action is to get that treated and reduced. If diabetes, you need to get that under control. Kidneys don't repair from chronic disease, but you can slow things down. Since dehydration is the primary cause of my CKD I went on mega doses of two anti diarrheals. I have tried to eliminate caffeine - I drank a lot of diet pop. I haven't got to zero because when we go out they never have anything but diet caffeinated pop. So I take a phosphorus binder for that at least. Several studies show a vegan diet can slow CKD. Most Dr. don't even mention it. It is difficult for many to maintain. I just can't. I'm so prone to ileostomy blockages that I can't have most all veggies. I avoid red meat and eat mostly chicken. For me, the anti diarrheals, the constant drinking, the caffeine reduction, and whatever has kept me hovering at stage 4 for 4 years. ALL the Dr. thought I'd be on dialysis by now. I was down to an eGFR of 7 and got on the transplant list (different long story of how hard that is in the US). But my eGFR bounced up to the 20s and has stayed there. CDK is not a one size fits all. Lot's of different causes. It's best to get those labs checked before blindly attacking salt, potassium and phosphorus. Reducing meat proteins, especially red meat, controlling whatever caused the CKD, tackling any issues that may prevent you from getting on the transplant list would be what I recommend.

Miss-guineapig profile image
Miss-guineapig in reply tobarbara55109

My GP will email me my blood results when I ask, so I’m lucky. X

Turttletools profile image
Turttletools

labs are important. I strictlyfolloqeda renal diet bwforw and into dialysis. Recently out of the blue, my potassium, which use to be high, dropped to 3.1

I quickly added potatoes, bananas and avocados, and am back up to 3.5.

They have no clue what happened, but they contonue to run potassium lab weekly so i can adjust diet.

Labs are kwy

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