Kidney Diet Tips


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Dietary Phosphorus Control to Prevent or Delay Kidney Failure

You may have chronic kidney disease (CKD) and not even know it. An estimated 17% of US adults have chronic kidney disease and many are undiagnosed. There are 5 stages of kidney disease: stage 1 CKD represents kidney damage with normal kidney function; stage 2 kidney disease is mild kidney disease; stage 3 chronic kidney disease is moderate kidney failure; stage 4 CKD is severe and stage 5 is end stage renal disease which requires dialysis or kidney transplant. If you have kidney disease and you’re looking for ways to preserve kidney function through diet, pay attention to this latest study published in the August 2011 online Journal of the American Society of Nephrology.

Carmine Zoccali, MD (CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Italy) and his colleagues studied the effect of phosphorus on the kidneys of chronic kidney disease patients and the effect on ramipril, a blood pressure medication often prescribed to slow kidney disease progression. Three hundred thirty one CKD patients were studied, divided into 4 groups based on their phosphorus level.

Finding from this study revealed that patients with the highest phosphate levels, even though normal or near normal, progressed to more advanced stages of CKD or kidney failure quicker than those in the 2 groups with the lower phosphate levels. An additional finding was that patients with the higher phosphate levels  did not benefit as much from ramipril’s action to slow loss of kidney function.

What does this mean to you? It means if you have CKD, your phosphate level can predict how fast you may advance to kidney failure and the effectiveness of ramipril or other medications prescribed to ‘save’ your kidneys. Normal phosphorus level is 2.6 to 4.7 mg/dL. According to this study, phosphate levels at the lower normal limit are more protective and as levels approach the higher normal limit and beyond, you lose that protection.

So the next question is “Do I need to follow a low phosphorus diet?” Further studies are needed to determine whether reducing phosphorus intake improves kidney health and helps medications work better to preserve kidney function.

You can start by learning the sources of dietary phosphate and limit the least healthy food products from your diet. For example, many packaged and processed foods contain phosphate additives. Read food labels and avoid those with ‘phos’ ingredients. Instead, move toward making home prepared foods with as many fresh, unprocessed ingredients as possible. Check ingredients on all canned and bottled beverages as these can contain hidden phosphorus. Pay attention to the recommended amount of meat and dairy for a healthy diet compared to the amount you usually eat. Try to fine-tune your portions to what your body needs to eliminate the excess. Your kidneys may thank you by lasting a lifetime!

To learn more about phosphorus and kidney disease sign up and play the DaVita Phosphorus ChallengeTM

.  Visit the Game Gallery for fun while learning about phosphorus or the Education tab for a collection of phosphorus education handouts, videos, tools and recipes.

Over 1,200 recipes modified to reduce phosphorus  are available on

Additional Kidney Diet Resources

Visit and explore these diet and nutrition resources:

DaVita Food Analyzer

DaVita Dining Out Guides

Today’s Kidney Diet Cookbooks

DaVita Kidney-Friendly Recipes

Diet and Nutrition Articles                                                      

Diet and Nutrition Videos

Kidney Smart® Virtual Classes

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Sara Colman, RDN, CDCES

Sara Colman, RDN, CDCES

Sara is a renal dietitian with over 30 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 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.