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Educational resources for renal medicine

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Phosphate control essential for prevention and management of renal bone disease, arterial stiffening and vascular calcification.

Phosphate in the diet generally associated with intake of protein: Meat, fish, chicken, eggs, yoghurts, cheese, milk

Typical UK intakes of phosphate: - Men: 47mmol/day - Women: 36mmol/day

When GFR deteriorates to 25-30ml/min, phosphate retention can occur. Level of restriction depends on treatment mode, residual renal function, dietary intake, and biochemistry. Phosphate not very well dialysed - relatively large ion, with small gradient as plasma concentration low (1-2mmol/l).

Aim to maintain serum phosphate <1.8mmol/l. Control can be achieved via combination of:

Low phosphate diet

  • Limit high phosphate foods (Cheese, yoghurt, eggs, nuts, milk, oily fish)
  • May have to restrict phosphate intake to approx 30mmol/day.
  • However, must maintain adequate protein intake

Phosphate binding medication:

Work in the stomach by binding the phosphate in foods - so should not be taken without food as will have no benefit

  • Calcichew, Phosex (Calcium containing)
  • Renagel, Alucap, Fosrenol, Lanthanum carbonate (Non-calcium containing)
Page last modified 19.03.2009, 21:23 by Administrator. edrep and edren are produced by the Renal Unit at the Royal Infirmary of Edinburgh and Univ. Edinburgh. CAUTIONS and Contact us. Note that the information published here is primarily intended for education, not for clinical care.