How Do Phosphate Binders Affect Blood Phosphate Levels?

In patients with chronic kidney disease, doctors are concerned with many elements of the diet. For example, many times protein is restricted prior to being on dialysis. Once a patient is on dialysis, the focus changes and protein is increased. This is because the dialysis equipment does the job of the kidneys in processing waste. The same can be said for other nutrients such as salt, phosphorus, and potassium.

While your kidneys still have the ability to do some level of filtering, dietary management through limiting protein, salt, potassium and phosphorus is managed by following a meal plan specified for the stage of kidney disease.  Phosphate in particular is associated with an increased mortality rates for every mg/dl above 5.6. As your body reduces its ability to filter phosphate, the increased levels of phosphate can be harmful to your cardiovascular system.

Phosphate binders are medications that when taken with a meal reduce the amount of phosphate absorbed. This in effect lowers the blood level of phosphate when taken consistently. Many doctors prescribe calcium containing phosphate binders and these should be taken with meals to reduce the overall absorption of phosphate and further damage to kidneys. What many people do not realize is that our bodies are very efficient at managing the levels of phosphate in the blood, and when your kidneys cannot process it correctly, it can raise the amount of PTH (parathyroid hormone).  Hyper parathyroid hormone levels can affect blood calcium which also affects heart functionality.

Dietary phosphate is generally found in protein containing foods and dairy products. Also, processed foods can contain high levels of phosphate as part of the manufacturing and flavor enhancers.  So in early kidney disease, it’s important to eat a diet that is lower in protein so as to naturally reduce the amount of phosphate that you are eating. Following a kidney pre-dialysis meal plan would involve lowering the sodium and protein you eat to help reduce the progression of the disease. You should consult with your dietitian for specific levels of nutrients needed in your diet.

Do you find it hard to stick to a low protein diet?  What foods do you miss the most?  Let me know in the comments…