Kidney Diet Tips

Kidney Diet Tips on Phosphate Additives – Your Great Phosphorus Saver (G.P.S.) Guide

DaVita Dietitian Julia from Ohio is today’s guest blogger with some great kidney diet tips about phosphorus.

Phosphorus by the Numbers

  • 250 mg to 1,000 mg of phosphorus is the amount removed in a dialysis treatment
  • 800 mg to 1000 mg of phosphorus per day is the typical daily target for a low phosphorus kidneydiet
  • 85% of fast food entrees and side dishes contain phosphate additives
  • 28% to 100% – a recent review of frozen chicken products revealed that the frozen chicken contained 28% to 100% more phosphorus than unenhanced fresh or frozen chicken.
  • 40% to 60% of the phosphorus that NATURALLY occurs in foods is absorbed into the bloodstream.
  • 90% to 100% of the phosphorus that is ADDED to foods, as a food additive, is absorbed into the bloodstream.
  • 100% of dialysis patients will benefit from avoiding foods with phosphate additives!

Just knowing that because your kidneys cannot remove phosphorus you need to avoid phosphate additives is the first step.  Knowing where these additives are found and how to avoid them is the all important next step.  Think of this article as your G.P.S. for phosphorus additives (G.P.S. – “great phosphorus saver”).

1. Know which foods typically have phosphate additives and in general try to avoid these foods.

  • Processed and convenience foods
  • Enhanced meat and chicken products
  • Canned or frozen biscuits and pancakes
  • Fast food pancakes and biscuits
  • Boxed biscuit, muffin, and pancake mix
  • Canned and bottled iced tea (some brands)
  • Cola beverages
  • Flavored waters
  • Breakfast bars
  • Bottled Coffee beverages
  • Processed or spreadable cheeses
  • Instant puddings and sauces
  • Lunch meats, hot dogs and chicken nuggets
  • Refrigerated bakery products

2. Be a label reader!

The ingredient list on food labels must list the ingredients in descending order of amount; in other words, the ingredient listed first is present in the greatest amount, the second is present in the second greatest amount and so on.  If a phosphate additive is listed early in the ingredient list or there are numerous phosphate additives in an ingredient list…avoid that food.  The following are some examples of phosphate additives:

  • Phosphoric Acid                             
  • Pyrophosphates
  • Polyphosphates
  • Hexametaphosphate
  • Dicalcium phosphate
  • Disodium phosphate
  • Potassium tripolyphosphate
  • Tetrasodium pyrophosphate
  • Sodium Polyphosphate
  • Phosphate
  • And many more… but notice they all contain the “phos”, making them a little easier to identify.


 3. Know how to use % Daily Value on the Nutrition Facts label to find out if a food is a low, medium or high phosphorus food (naturally occurring and additives). 

Many foods, such as cereals, list the % Daily Value for phosphorus.  Use the following guide to determine the amount of phosphorus in foods:

  • Less than 5% Daily Value = 0-50 mg phosphorus = low phosphorus food-Enjoy!
  • 5-15% Daily Value = 51-150 mg phosphorus = medium phosphorus food – Limit!
  • Greater that 15% Daily Value = 150 mg phosphorus = high phosphorus food – Avoid!

4. Keep in mind that fresh, homemade foods are lower in phosphorus and are much better for you! 

Remember the numbers… 85% of fast food entrees and side dishes contain phosphate additives… avoid fast food as much as possible.  Phosphate additives are used for many reasons – increasing shelf life, making foods creamier, keeping powders from clumping, but these additives can easily be avoided by discovering the cook inside of yourself!  Convenience and fast foods are full of phospate additives so it’s best to limited your intake.  By simply making some foods from scratch, you can avoid a lot phosphorus–and sodium too!.  Some examples of foods that would be much lower in phosphorus without the additives include:

  • Instant oatmeal (high) ——————Regular oatmeal (low)
  • Instant rice (high) ————————Regular rice (low)
  • Bottled teas (high) ————————Homemade tea brewed from tea bags (low)
  • Pancake mix (high) ———————–Pancakes made from scratch (medium)
  • Fast food hamburger (high) ————-Homemade 100% beef hamburger (low)

Fresh is always better!  Become a cook and go to for hundreds of kidney-friendly recipes.  If computers are not your thing, then ask your dietitian to print some recipes for you!

 Knowing where to find the hidden sources of phosphate additives will enable you identify sources of phosphorus in your food.  By avoiding these foods, (and taking prescribed phosphate binders when you eat) you will be on your way to good phosphorus control.  It is so important to keep your phosphorus level consistently at 5.5 or less if you are on dialysis or 4.6 or less if you have chronic kidney disease (CKD) without dialysis.  High phosphorus levels can lead to: itching, red eyes, calcium-phosphorus deposits in the heart (early heart attack), calcium- phosphorus deposits in skin, lungs, blood vessels, and other organs, bone disease, and increased risk of death.  Always know your numbers… know what your calcium, phosphorus and PTH levels are and if they are controlled. Talk with your Dietitian and other health care team members about these numbers. 

Knowledge is key… continue to seek out more information about phosphorus and phosphate additives… keep your G.P.S. (“great phosphorus saver”) heading in the right direction!

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Sara Colman, RD, CDE

Sara is a renal dietitian with over 20 years experience working with people with diabetes and kidney disease. She is co-author of the popular kidney cookbook "Cooking for David: A Culinary Dialysis Cookbook". Sara is currently the Manager of Kidney Care Nutrition for DaVita. She analyzes recipes and creates content, resources and tools for the kidney community. In her spare time Sara loves to spend time with her young grandson, including fun times together in her kitchen.