Phosphorus and Calcium

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Phosphorus is a mineral used by your body to make bones and teeth, and to use and store energy.

Healthy kidneys get rid of phosphorus in the urine. In kidney failure, the phosphorus level can become too high. Phosphorus is not removed very well in dialysis because it is a big molecule. If it is not treated, you will have the problems caused by a high phosphorus level.

When the phosphorus level in your blood is too high, calcium will be pulled from the bones. This can form a calcium-phosphorus substance in the blood. When this settles in the muscles and body organs, it is called a, “calcium deposit”. It is painful when it is in your feet and harmful in the blood vessels or body organs (which includes the heart).

Each month your phosphorus level will be checked. The level of phosphorus in your blood will help determine if you are eating too many high phosphorus foods and if you need to be on medication to help control the phosphorus level in your blood.

The desired level of phosphorus is 3.5 – 5.5

To keep phosphorus at the correct level, you may need to take a phosphate binder (i.e. Tums, Phoslo, or Renagel) with ALL of your meals and snacks. This will bind much of the phosphorus in foods you eat, and will not allow it to enter your blood. The excess phosphorus will leave your body by way of the digestive system. Each month your calcium level will be checked. With kidney failure the calcium levels tend to run high and supplements are not recommended unless your doctor prescribes it.

The desired level of calcium is 8.3 – 9.5

Bone disease develops over time and occurs faster if your PO4 and Calcium are high. You may not notice any problems right away, but be aware of the following signs:

  • Itching
  • Pain in joints and bones
  • Abnormal blood values for phosphorus or calcium
  • Easily broken bones
  • Bony calcium deposits (painless hard or soft lumps) under your skin, in your heart and/or your lungs

There are several things you can do to prevent this from happening:

  • Limit the high phosphorus food in you diet
  • Take your phosphate binders as prescribed with meals and snacks
  • Get enough dialysis – do not cut short your treatment time
Foods which are high in phosphorus include:
  • Milk and Dairy products (limit to 1 cup/day)
  • Cheese
  • Meat, fish, poultry, eggs (You need to eat 6-8 oz of these per day for protein!!)
  • Nuts
  • Dried beans
  • Some vegetables
  • Whole grains
  • Chocolate
  • Beer and Dark Cola drinks
Low Phosphorus Foods – (80mg or less)

Beverages:

Alcohol (hard), 3 oz.- 10mg
Coffee, Tea 1 c. - 5mg
Soda Pop (NOT COLA), 12 oz.- 50mg

Breads and Cereals:

Bread, white, 1 slice - 20mg
Bread, whole grain - 50mg
Crackers, 2 - 10 mg
Cream of Rice, 1 c. - 65mg
Cream of Wheat 1 c. - 40mg
Pancakes, 1 (4-inch) - 65mg
Pasta, 1/2 c. - 45 mg
Puffed Rice, 1 c. - 30mg
Puffed Wheat, 1 c. - 30mg
Special K, 1 c. - 30mg
Sugar Pops, 1 c. - 8mg

Dairy Products:

Butter, Marg., 1 Tbsp - 2mg
Cream Cheese, 1 oz.- 30mg
Half & Half, 1 Tbsp - 15 mg
Sherbet , 1/2 c. - 40 mg
Sour Cream, 2 Tbsp - 20mg
Whipping Cream, 1 Tbsp - 10mg

Fruits:

All Fruits, 1/2 c. - 40mg

Meats, Fish, and Poultry:

Bacon, 1 strip - 20mg
Beef, 1 oz.- 60mg
Clams, Oysters, 1 oz.- 50mg
Fish, white 1 oz.- 60mg
Ham, 1 oz.- 60mg
Lamb, 1 oz.- 60mg
Pork, 1 oz.- 55mg
Shrimp, 1 oz.- 50mg (high in potassium)
Tuna, 1 oz.- 65mg
Turkey, white 1 oz.- 55mg

Vegetables:

Any not listed under medium and
highphosphorus foods below

Snacks and Desserts:

Cake, 1 slice - 65mg
Caramels, 2 - 20mg
Chocolates, 1 oz.- 60mg
Coconut, 1/2 c. - 60mg
Cookies, plain, 1 - 10mg
Corn chips, 1 oz.- 45mg
Potato chips, 1 oz.- 45mg
Fruit pie, 1/8 pie - 35mg
Marshmallows, 4 reg. - 4mg
Popcorn, 1 c. popped - 40mg

Miscellaneous:

Jams, Jellies, 1 Tbsp. - 2mg
Sauces, sugars, syrups - 5mg
Shortening, Oils, 1 Tbsp. - 0mg

Dairy Substitutes:

Meadow Fresh, 1/2 c. - 60mg
Mocha Mix, 1/2 c. - 60mg
Poly Rich, 1/2 c. - 45mg

Medium Phosphorus Foods – (80 - 199mg)

Beverages:

Beer, 12 oz. - 110mg
Tang, 1 c. - 150mg
Colas, 12 oz. - 90mg

Breads and Cereals:

Cheerios, 1 c. - 115mg
Oatmeal, 1 c. - 160mg
Shredded Wheat, 1 reg. - 100mg
Waffles, homemade 1 - 130mg
Wheat germ, 1 Tbsp. 110mg

Dairy Products:

Cheddar cheese, 1 oz.- 135mg
Cottage cheese, 1 oz.- 170mg
Frozen yogurt, 1/2 c. - 100mg
Ice cream, 1/2 c. - 80mg
Mozzarella cheese, 1 oz.- 105mg

Meats, Fish, and Poultry (cooked):

Remember, you need 6-8 oz.per day!!!

Chicken, 1 oz.- 70mg
Cod, 1 oz.- 80mg
Egg, 1 - 100mg
Liver, beef, 1 oz.- 155mg
Salmon, 1 oz.- 100mg
Scallops, 1 oz.- 95mg
Turkey, dark meat, 1 oz.- 115mg

Vegetables:

Lentils, split peas, 1/2 c. - 130mg
Lima Beans, 1/2 c. - 80mg
Mushrooms, 1/2 c. - 120mg
Pinto, Garbanzo Beans, 1/2 c. - 130mg

Snacks and Desserts:

Custard, 1/2 c. - 150mg
Peanut butter, 2 Tbsp. - 120mg
Cream Pie, 1/8 pie - 100mg
Pudding, 1/2 c. - 120mg

High Phosphorus Foods – (200mg or more)

Breads and Cereals:

All Bran, 1/3 c. - 265mg 100% bran 3/4 c. - 400mg
Bran Flakes 1 c. - 300mg
Waffles, from mix or frozen - 255mg

Dairy Products:

Buttermilk, 1 c. - 220mg
Cheese, parmesan, 1 oz.- 215mg
Cheese, American, 1 oz.- 215mg
Cheese spread, 1 oz.- 215mg
Cocoa, 1 c. - 270mg
Milk, chocolate, 1 c. - 255mg
Milk, white, 1 c. - 230mg
Yogurt, 1 c. - 270mg

Miscellaneous:

Pizza, 1 slice (med) - 200mg
Pumpkin seeds, 1 oz.- 333mg
Nuts, 1/2 c. - 260mg