Phosphorus is a major mineral found throughout the body. Phosphorus is controlled as part of normal, healthy kidney function. When the kidneys do not work effectively, the level of phosphorus accumulates in the body. Your dialysis clinic measures the amount of phosphorus in your blood during the monthly laboratory tests.
High serum (blood) phosphorus levels can cause many problems. The most common problem is with your bones. When your phosphorus is too high, it may encourage the calcium in your bones to move. The calcium moves from the bones to match the level of phosphorus in the blood, like two people holding hands. This process can cause the bones to have less calcium than they need to stay strong. Many other things may be happening when your blood phosphorus is too high. Most of these things you cannot feel and may not know about until you have problems several months, or even years, later. By then, the problems cannot be easily fixed.
Phosphorus is found in many foods. The most common foods are dairy products or foods that contain milk. Examples are cheese, milk, yogurt, and ice cream. Phosphorus is also found in legumes, and in dried peas and beans. Phosphorus is often also found in protein products like liver and meat. It is often difficult to follow a low phosphorus diet.
To help keep the blood phosphorus to a normal level, you may be asked to take phosphate binders. These binders are medications that remove the phosphorus from the food as it’s being digested. The phosphorus is then moved through your system in a “bound form.” Think of it as putting the extra phosphorus in a clear sandwich bag. You can see it, but it cannot get out of the bag. The phosphorus in the “bag” or the “bound state” now moves through your intestinal system without being absorbed. It leaves your body through your stool. It does not go into your blood stream.
You must take your phosphate binders at the right time to “grab” the phosphorus in the food you are eating. Your phosphate binder won’t work right if you don’t take enough binders or don’t take them at the right time. There are many binders on the market so ask your health care provider what binder choices are right for you.
It is very important to know about phosphorus. If you need more information, ask your dietitian or health care provider. They can often help you learn more about the foods you are eating and how you can protect your bones. Strong bones help you remain active and healthy.
Keeping your blood phosphorus in the normal ranges each month is a good step you can take to keep you healthy and feeling good while on hemodialysis.
About the Author
Judy Beto, RhD, RD, has over three decades of hands-on renal nutrition experience as one of the earliest renal dietitians. She was the first editor of the Journal of Renal Nutrition. Currently she manages clinical trials for hemodialysis patients at Loyola University Medical Center and is a professor in the department of Nutrition Sciences at Dominican University.
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