Your Kidney Disease Diet: Managing Phosphorus

As you navigate your diagnosis of chronic kidney disease, your doctor will likely have some advice for you in the way of foods and nutrition. You have been told that your kidneys are not filtering your blood as well as they should and this may affect your body’s mineral balance. So what does this have to do with nutrition?

There are several nutrients that should be kept in check when you are dealing with kidney disease. In particular, phosphorus is a mineral that is important for many body functions. It is found in your bones and helps your body build cells and helps energy transfers throughout the cells. When kidneys are working normally, they remove extra phosphorus in the blood.  But, when your kidneys aren’t working well, your body is not able to get rid of the extra phosphorus. Having too much phosphorus can affect the balance of other minerals in your blood. A specific balance between the amount of calcium and the amount of phosphorus is vital. If the extra phosphorus cannot be released from your body, it will build up in your blood. This buildup causes calcium to be pulled from your bones in an effort to regain that needed balance. If too much calcium is pulled, your bones may become brittle and weak.

You may be taking phosphorus-binding medicines prescribed by your doctor to help your body get rid of extra phosphorus. Taking binders as prescribed is important. There are also some foods you should steer clear of, or limit, in order to avoid phosphorus-related problems.

Lower-Phosphorus Alternatives to Choose:

  • Fresh fruits and vegetables
  • Rice milk, unenriched
  • Breads
  • Pasta
  • Rice
  • Fish
  • Corn and rice cereals
  • Soda without phosphate additives
  • Home-brewed ice tea

High Phosphorus Foods to Avoid or Limit:

  • Dairy foods
  • Beans
  • Lentils
  • Nuts
  • Bran cereals
  • Oatmeal
  • Colas and other drinks with phosphate additives
  • Some bottled ice tea

Some foods may also contain phosphate additives that could add up to 1000 mg/day of phosphorus to your diet. Since you have likely been asked by your doctor to limit your phosphorous to 800-1000mg/day, these are additives you should be aware of. Some foods that contain these additives are:

  • Processed meats
  • Instant puddings and sauces
  • Spreadable cheeses
  • Beverage products

It’s important to read the label of every item you pick up in the grocery store and look for ingredients with “phosphate” or “phos” in their names, such as phosphoric acid, sodium aluminum phosphate, pyrophosphate, polyphosphates and calcium phosphate.  When you find them, avoid or limit those foods.

A dietitian experienced in managing a kidney disease diet can also help. Find one at the American Nutrition and Dietetics website:

You can, in partnership with your health care team, help control the effects of your kidney disease. A healthy, balanced diet with careful attention to phosphorus intake can help you do that.



Nelms, M., Sucher, K., Lacey, K., & Long Roth, S. (2011). Diseases of the Renal System. In Nutrition Therapy & Pathophysiology (2nd ed., p. 841). Belmont, CA: Wadsworth.

Gropper, S., Smith, J., & Groff, J. (2009). Macrominerals. In Advanced Nutrition and Human Metabolism (5th ed., p. 600). Belmont CA: Wadsworth.

Posted: | Author: Lauren Elkins

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