Nutrition & Dialysis

Nutrition & dialysis
Nutrition & dialysis
Nutrition & dialysis

The Role of Phosphorus in Chronic Kidney Disease (CKD)

What is phosphorus, and what does it do?

Phosphorus is your body’s second-most abundant mineral. Some of its many functions include:

  • Energy release
  • Forming bones and teeth
  • Maintaining a neutral acid-base balance
  • Facilitating countless metabolic processes

Why is phosphorus a problem for those with CKD?1

Healthy kidneys, with the help of multiple hormones, work to maintain a certain level of phosphorus in the blood. Normally, kidneys excrete excess phosphorus. In CKD, however, phosphorus can accumulate to unhealthy levels in the blood (hyperphosphatemia) and bind with calcium to create calcium deposits outside the bones. In turn, this imbalance can lead to a variety of mineral metabolism disorders.1

Where does phosphorus come from?

Naturally occurring in foods, phosphorus can be especially high in protein-rich foods.1 Consuming low-phosphorus food choices, such as those listed below, and Nepro®, can help you manage your intake of this important mineral.

Poor phosphorus choices

  • Beer, cocoa, chocolate drinks, dark sodas, bottled beverages with phosphate additives
  • Cheese, custard, milk, cream soups, liquid nondairy creamer, ice cream, pudding, non-Greek-style yogurts
  • Oysters, sardines, fish roe, beef liver, chicken liver
  • Chocolate, caramels, oat bran muffins, most processed/prepared foods, pizza

Good phosphorus choices

  • Fresh fruits such as apples, apricots, blackberries, grapes, tangerines, pears, peaches, pineapples, plums, strawberries
  • Fresh vegetables such as cauliflower, carrots, cucumbers, celery, green beans, broccoli
  • Popcorn, crackers
  • Rice cereal
  • Sherbet, sorbet
  • Coffee or tea without milk, light-colored sodas, fruit juices

Managing phosphorus intake2

When phosphorus levels are too high, certain medications and nutritional supplements may be needed to help restore balance. The following tips may help you as you learn to manage your phosphorus intake:

  • Read food labels. Phosphorus is not required to be listed by law, so it may not appear on the food label even if the product does contain phosphorus3
  • Be aware that many fast foods are high in phosphorus
  • Watch out for hidden phosphorus in high-protein diets. Consult with your healthcare professional about the protein-to-phosphorus ratio that’s right for you


1. Phosphorus and Your CKD Diet. National Kidney Foundation website. Accessed May 15, 2018.
2. Wilkens, K. How to Be a Phosphorus Detective. National Kidney Foundation website. Accessed May 15, 2018.
3. National Kidney Foundation website. Accessed May 15, 2018.

Ask your healthcare professional for more information about Nepro.
Use under medical supervision.

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