Reducing phospate in your diet - ouh.nhs.uk · Reducing phosphate in your diet | Oxford Health NHS...

Nutrition and Dietetics Older People Directorate

Reducing phosphate in your

diet

Nutrition and Dietetics

2 Oxford Health NHS Foundation Trust | www.oxfordhealth.nhs.uk

Contact details

Oxford clinics

If you would like to see the dietitian, we are available in the

clinic each morning. Please ask the receptionist to inform the

dietitian if you would like to be seen.

Satellite unit clinics

Some of these clinics are covered by a dietitian. Please ask the

receptionist if you would like to be seen.

Alternatively you may call the above telephone number which

has a 24-hour answerphone service. Messages are checked

Monday to Friday.

Oxford renal dietitians telephone: 01865 225 061

Swindon renal dietitians telephone: 01793 605 292

Reducing phosphate in your diet

www.oxfordhealth.nhs.uk | Oxford Health NHS Foundation Trust 3

What is phosphate?

Phosphate is a mineral naturally found in many foods in your

diet.

Why is my phosphate level high?

Phosphate levels in the blood can increase when the kidneys

are not working properly.

The target phosphate levels are:

0.9 - 1.5mmol/L for a chronic kidney patient

1.1 - 1.7mmol/L for a dialysis patient

What happens if my phosphate level is too

high?

High blood phosphate levels may initially cause red eyes and

itchy skin.

Prolonged high blood phosphate levels can lead to:

brittle bones that are more susceptible to breaking

aching joints

hardened blood vessels, increasing your risk of heart

disease and circulation problems



What can I do to control my phosphate level?

The first step to controlling your phosphate level is to follow a

low phosphate diet. You may also be prescribed phosphate

binder tablets.

How to achieve a low phosphate diet

Using this guide should help you choose suitable foods that

you enjoy while keeping your phosphate level controlled.

Eggs are not included in the table opposite. They are a good

source of protein but do contain a moderate amount of

phosphate. It is recommended that you eat no more than four

eggs per week.

Processed foods often have phosphate added to them. When

looking at food labels try to limit those that contain the words

phosphate or phosphoric acid. In particular, look out for these

ingredients in ham, breaded chicken, cake mixes, instant

sauces and dark-coloured fizzy drinks. Try to avoid consuming

these products regularly.

Dairy foods are high in phosphate but also contain essential

nutrients such as protein and calcium. In order to have enough

of these nutrients but not too much phosphate, choose two or

three points from the table opposite each day.



Condensed and evaporated milk are very high in phosphate so

avoid these. Cream can be taken in small quantities.

Dairy products: choose two - three points per day from

the options below

Three points

300ml (1/2 pint) cow’s milk (whole cream, semi-skimmed,

skimmed or UHT) or soya milk (fortified)

Two points One point

200ml (1/3 pint) cow’s milk or

soya milk (fortified)

100ml (1/2 cup) cow’s milk or

soya milk (fortified)

30g (1oz) of the following

hard cheeses:

Cheddar

Edam

Red Leicester

30g of the following cheeses:

Brie

feta

mozzarella

Stilton

15g parmesan cheese 60g cottage cheese or ricotta

150ml custard 2 scoops (120g) ice cream

200ml milk pudding 1 pot (90g) crème caramel

1 pot (150g) yoghurt 1 pot (125g) soya yoghurt

2 tbsp Greek style yoghurt 1 pot (100g) fromage frais

3 tsp (10g) dried milk powder 200ml oat, rice or soya

(unfortified) milk



The following table lists foods which are high in phosphate and

need to be avoided or consumed only occasionally. It also lists

foods which are lower in phosphate and can be chosen as

suitable alternatives.

Foods high in phosphate

to avoid

Lower phosphate

alternatives

Fish with edible bones such

as sardines, pilchards and

whitebait

Shellfish

Boneless tinned fish

Fresh, unprocessed fish such

as cod, haddock,

tuna and salmon

Processed meats such as

tinned meat and burgers

Liver and kidney

Fresh, unprocessed meat such

as beef, pork, chicken and

lamb

Nuts Corn snacks, rice cakes, bread

sticks

Peanut butter Jam, marmalade

Chocolate bars Plain biscuits or thinly

coated chocolate bars

Drinks such as cola,

Dr Pepper and drinking

chocolate and malted drinks

such as Horlicks

Tea

Fruit squashes, other fizzy

drinks

Condensed milk, evaporated

milk

Small quantity of cream

Naan bread, crumpets,

muffins and scones

Chapatti, toast, madeira cake,

teacake and plain biscuits



Try swapping sardines and pilchards for fresh,

unprocessed fish like salmon or cod.



Phosphate binders

To reduce the amount of phosphate you absorb from your

food you may have been prescribed a medicine called a

phosphate binder.

Please see the list of phosphate binders below and how to take

them.

Phosphate binder How to take it

Calcichew/Calcium 500 (calcium

carbonate)

Osvaren (calcium acetate and

magnesium carbonate)

Chew thoroughly

immediately before food

Renagel (sevelamer hydrochloride)

Renvela tablets (sevelamer

carbonate)

Phosex/Phoslo (calcium acetate)

Alucaps

Swallow whole after two to

three mouthfuls of each

meal

Renvela powder (sevelamer

carbonate)

Dissolve in 60ml water and

take with meals

Fosrenol powder (lanthanum

carbonate)

Sprinkle over food and

consume within 15 minutes

Fosrenol tablets (lanthanum

carbonate)

Chew thoroughly

immediately after each meal



Phosphate binders continued

It doesn’t work as effectively, but if you forget to take a

phosphate binder you can still take it within 30 minutes of a

meal.

If you eat away from home (this includes attending dialysis)

please carry some binders with you. You can ask your dietitian

for a pill pot.

Your dietitian can advise on how best to match your binders to

your meal pattern as well as which snacks require a phosphate

binder.

If you have problems tolerating your phosphate binder please

inform your renal doctor.



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Concerns and complaints

We aim to provide you with a high quality service at all times.

However, if you have any concerns, complaints or comments

about your experience of our service then please tell a member

of the team or contact the PALS and complaints team on

freephone 0800 328 7971.



Oxford Health NHS Foundation Trust

Trust Headquarters

Warneford Hospital

Warneford Lane

Headington

Oxford

OX3 7JX

Switchboard 01865 901 000

Email [email protected]

Website www.oxfordhealth.nhs.uk

OP 058.14

Our Older People Directorate includes community services which also provide care

for adults of a working age and young people.

mailto:[email protected]

http://www.oxfordhealth.nhs.uk/

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