University Teaching Trust
Controlling your
Phosphate Intake: Step 1
Ladywell Building
Dietetic Department
0161 206 1994
© G15121506W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015.
Document for issue as handout. Unique Identifier: CS57(15). Review date: January 2018.
What are Phosphate and Calcium?
Name:
Phosphate and calcium are
minerals that come from the
food you eat and are needed to
maintain strong healthy bones.
Dietitian:
0161 206 1994
[email protected]
Your kidneys help to control the
levels of phosphate and calcium
in your blood. Phosphate and
calcium work together to keep
your bones, teeth, heart and
blood vessels healthy.
These levels are difficult to
control when the kidneys are
no longer working properly.
An imbalance can lead to
weakening of the bones and
a build up of calcium in blood
vessels.
If your levels of calcium and
phosphate go too high in
your blood then this can cause
serious problems.
1
Symptoms of a high blood
phosphate level are:
l Itchy skin and eyes
l Bone pain and tenderness
l Weak bones that may break
more easily
l Joint pain in the lower back,
hips and thighs
l Painful feet
l Muscle weakness and
problems walking
l Cold, tingling hands and feet
If high levels continue then
‘calcification’ may result. This
occurs when calcium and
phosphate join together to
form hard deposits.
These deposits can form in
the heart, lungs, blood vessels
and joints. This can lead to
many problems including heart
disease and put your chances of
having a transplant at risk.
© G15121506W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS57(15). Review date: January 2018.
2
How can I control the level of phosphate in my blood?
To help you control your phosphate levels, you will need to reduce
the amount of phosphate in your diet.
Meats
Veal, game, liver, kidney, heart, sweetbreads, pate.
Fish
Tinned fish with bones, e.g. pilchards, sardines. Fish roe,
kippers, whitebait, sea bass, monkfish, coley.
Daily / Weekly Allowance
Shellfish
Clams, Crab (fresh), scallops, scampi
Milk
/2 pint (300mls) of milk per day. This can be skimmed,
semi-skimmed or full fat.
1
/3 pint (190mls) of milk can be swapped for a yoghurt or a
portion of custard or milky pudding.
Cereals
Cheese
4oz (100g) hard cheese per week e.g. Cheddar, Edam,
Lancashire, Red Leicester. Soft cheeses e.g. Brie, ricotta,
feta are lower in phosphate. Alternatively choose cottage
cheese (various flavours) or cream cheese.
All bran, muesli and cereals containing nuts. Biscuits
containing chocolate and nuts. Cakes and biscuits
containing baking powder e.g. scones, crumpets. Puri
with added baking powder. Savoury Indian snacks (e.g.
chevda, gathia, sev).
Drink
Malted milk drinks, drinking chocolate, cocoa, cola drinks.
Dairy foods are high in phosphate and need to be moderated.
Follow the guidelines below:
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In addition try to avoid the following high phosphate foods:
1
Eggs
4 eggs per week; boiled, fried, poached or scrambled.
Milky
Puddings
In addition you may also have a maximum of 4 items from
the following list each week:
l 125g pot of yoghurt
l 125g custard (small bowl)
l 125g milk pudding (small bowl)
l 100g ice cream (2 scoops)
Miscellaneous Nuts, chocolate, fudge, any Indian sweets containing
milk powder or ground nuts. Other nuts (e.g. almonds,
peanuts), twiglets, yeast, extract (e.g. marmite, Bovril),
peanut butter, naan bread, pizza.
l Try to avoid using too many
processed foods as phosphates
are often used as preservatives
and additives. You can often
see the word ‘phosphate’ or
‘phos’ in the ingredients list
e.g. phosphoric acid. This type
of phosphate is very easily
absorbed from your food, (see
separate phosphate additives
leaflet for more information)
l Where possible, use
fresh foods to avoid the
preservatives and additives
© G15121506W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS57(15). Review date: January 2018.
4
Phosphate binders
In addition to limiting the
amount of phosphate in your
diet, you may also be prescribed
some tablets known as
phosphate binders.
These tablets act like a sponge
and bind with the phosphate
in your food to stop it being
absorbed into your body.
Phosphate binders must be
taken with all meals containing
phosphate as prescribed by your
doctor.
The most commonly prescribed
phosphate binders are shown
below:
lPhosex (calcium acetate)
lRenacet (calcium acetate)
lOsvaRen (calcium acetate and
magnesium carbonate)
How to take your
Phosphate binder
Notes
l Phosex
l Renacet
l OsvaRen and Renagel/Renvela
Should be taken with food and
lFosrenol
Should be taken after food.
Further information about
controlling your phosphate
level is available from your
dietitian.
Renal Dietitians
0161 206 1994
renaldietitians@srft.
nhs.uk
lRenagel (sevelamer
hydrochloride)
lRenvela (sevelamer carbonate)
lFosrenol (lanthanum
carbonate)
5
© G15121506W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS57(15). Review date: January 2018.
6
© G15121506W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2015
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Unique Identifier: CS57(15)
Review Date: January 2018
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