Press "Enter" to skip to content

Phosphorus and Calcium

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