I Hate Dialysis Message Board
Welcome, Guest. Please login or register.
March 28, 2024, 08:05:57 AM

Login with username, password and session length
Search:     Advanced search
532606 Posts in 33561 Topics by 12678 Members
Latest Member: astrobridge
* Home Help Search Login Register
+  I Hate Dialysis Message Board
|-+  Dialysis Discussion
| |-+  Dialysis: Diet and Recipes
| | |-+  So confused abot phosphorus! Help!
0 Members and 1 Guest are viewing this topic. « previous next »
Pages: [1] 2 Go Down Print
Author Topic: So confused abot phosphorus! Help!  (Read 14201 times)
hillary
Newbie
*
Offline Offline

Posts: 44

« on: March 13, 2014, 01:00:19 PM »

Although I am taking 3 Renvela tabs with meals and 2 with snacks, my phosphorus is still above 7.0. I dont know what I am doing wrong... I do not eat cola, legumes,  chocolate, smoked or cured meats or any of the obvious stuff.  Are plain proteins high in phosphorus? I try to snack on fresh turkeyy breast, hard boiled egg, o boiled chicken breast because my albumin is low and I was told I need more protein.
Logged
cassandra
Elite Member
*****
Offline Offline

Gender: Female
Posts: 4974


When all else fails run in circles, shout loudly

« Reply #1 on: March 13, 2014, 01:28:55 PM »

Did you speak to your dietitian ?
Logged

I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
2020 start Gambro AK96

       still on waitinglist, still ok I think
obsidianom
Elite Member
*****
Offline Offline

Gender: Male
Posts: 1271

« Reply #2 on: March 13, 2014, 01:35:30 PM »

What kind of dialysis do you do? It is possible you are not removing enough phosphorus as well as ingesting too much. How are the rest of your numbers? What about your parathyroid numbers and calcium?  What is your BUN  pre and post if on hemo and if on hemo how many hours are you on ?
Logged

My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #3 on: March 13, 2014, 01:46:16 PM »

Eggs are high in phosphates (recommended no more than 3 a week) as are most dairy products (milk, cheese, yoghurt)
All meat contains phosphate but depends on the portion size but sadly the higher the protein, the higher the phosphate.

Refined white bread, crackers, cereal, white rice and pasta are lower...
so is seafood and canned tuna
feta and cottage cheese are a lot lower than hard cheese
 
Hope that helps  :P
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
cattlekid
Elite Member
*****
Offline Offline

Gender: Female
Posts: 1269

« Reply #4 on: March 13, 2014, 01:50:11 PM »

Also, check your foods and beverages for inorganic phosphates. Those are the sneaky ones.  They are in everything it seems.  Just look for phosphate on the label, it might have a prefix like triphosphate or something like that.  Phosphorus binders work relatively well to remove organic phosphorus but not so much the phosphorus in inorganic phosphates.  Also, are you taking your binders at the beginning of your meal?  Taking them at the end does not work as well. 

Good luck....when I was on hemo (home and in center) phosphorus was the bane of my existence. 
Logged
noahvale
Guest
« Reply #5 on: March 13, 2014, 02:03:23 PM »

^
« Last Edit: September 19, 2015, 06:40:40 AM by noahvale » Logged
hillary
Newbie
*
Offline Offline

Posts: 44

« Reply #6 on: March 13, 2014, 02:04:04 PM »

The dietician at my center is absolutely useless. All she says over and over is to take more binders. I cannot possibly take anymore. They go right through me.  I take them at the beginning of meals and snacks.
The neph there is useless as well because he is never around.
My other numbers are good, it's only the phos that I am having trouble with.
I am extremely frustrated, I feel like I have no one to go to about this.

Most food packaging does not list phosphorus at all so I don't see how I can look at packaging.
Logged
noahvale
Guest
« Reply #7 on: March 13, 2014, 02:59:03 PM »

*
« Last Edit: September 19, 2015, 06:39:47 AM by noahvale » Logged
cattlekid
Elite Member
*****
Offline Offline

Gender: Female
Posts: 1269

« Reply #8 on: March 13, 2014, 02:59:48 PM »

I agree, it sucks that phosphorus is not listed specifically on nutritional info on packaging.  But it will be on the ingredient list as phosphate.  That is what is so tricky.  You may have a favorite packaged food that is high in phosphate that might be causing a problem even though it's not on the standard no-no list.

This is why it aggravates me to no end that renal dietitians are spread so thin.  Your dietitian should be working through this with you, of course, I am preaching to the choir on this.  Most dietitians and other renal support workers have such a large patient load that they can't spend the time with their patients that they should be on nailing stuff like this down so they go for the easy out like "take more binders".

Have you told anyone about your issues with the binders running through you?  There is more than one type of binder available.  Fosrenol is an alternative to Renvela as is calcium acetate (unsure of the brand name).  I was on calcium acetate and Renvela both when I was on dialysis to keep my phosphorus down. 
Logged
obsidianom
Elite Member
*****
Offline Offline

Gender: Male
Posts: 1271

« Reply #9 on: March 14, 2014, 03:37:01 AM »

How many hours do you do dialysis weekly? One of the issues with just 3 day per week fairly short sessions that we do in the US is constant phosphorus issues like this. Dr. Agar in Australia has commented on this to me in our discussions as over there with more lengthy dialysis they dont see this happening. It may be you need more dialysis? Even if your numbers look good for US standards it still may indicate you need more due to the chronic phosphorus issue. It may not be just your diet.

More time on machine leads to lower phosphorus. Perhaps you can ask your nephrologist to slightly lengthen you sessions by an hour per day more.
« Last Edit: March 14, 2014, 08:34:03 AM by obsidianom » Logged

My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
hillary
Newbie
*
Offline Offline

Posts: 44

« Reply #10 on: April 05, 2014, 11:35:42 AM »

Honestly, I can barely get throuh the 3.5 hours I'm on right now.  The thought of staying on for longer is very difficult for me.  I go through horrifying RLS and I have to get very doped up on Klonopin in order to deal with being on the machine at all.   I want to investigate home hemo .  That might help the situation.   But anyway, my doctor added Phoslo in addition to the Renvela and it seems to be working. My phos went from 6.5.to 5.5 in a week and a half.
Logged
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #11 on: April 06, 2014, 12:25:33 AM »

Honestly, I can barely get throuh the 3.5 hours I'm on right now.  The thought of staying on for longer is very difficult for me.  I go through horrifying RLS and I have to get very doped up on Klonopin in order to deal with being on the machine at all.   I want to investigate home hemo .  That might help the situation.   But anyway, my doctor added Phoslo in addition to the Renvela and it seems to be working. My phos went from 6.5.to 5.5 in a week and a half.
i remember when I first started dialysis (and I was only doing 3 hour sessions) and I found sitting in the chair for this time incredibly difficult. I would almost be screaming by the end of it, often asking to be took off early just to get out of chair. I dreaded every session.
It does get easier slowly... though the restless legs syndrome doesn't change much.
Doing something to take your mind off it (listening to music on headphones and close your eyes or doing a crossword or Sudoku that requires full concentration) are good distraction techniques, as is eating!!!
Good luck  :(
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
ianch
Jr. Member
**
Offline Offline

Gender: Male
Posts: 95


WWW
« Reply #12 on: April 06, 2014, 02:20:47 AM »

Ironically its those short bazooka dialysis sessions that make dialysis hard and forces adherence to strict dietary requirements. I do 160 hours a month at very slow speeds and I having a great life and eat what I want with no binders in sight. 

Completed a 12 hour session last weekend to head off a cold I was developing.  Worked a treat and oh what an energy rush. Was a very productive Sunday on manual labor.
Logged

Ian Chitty
ESRD suffer, IT specialist, and business owner
(<2yrs) 1Y in-center, 9 months HomeD, 4 weeks tourism dialysis (Philippines/Singapore)

https://kiwimedtec.com
The aim of KiwiMedTec is to develop online solutions and partnered networks for dialysis patients, to make coping with kidney disease a little bit easier.
Zach
Elite Member
*****
Offline Offline

Gender: Male
Posts: 4820


"Still crazy after all these years."

« Reply #13 on: April 06, 2014, 02:34:56 AM »


Although I am taking 3 Renvela tabs with meals and 2 with snacks, my phosphorus is still above 7.0. I dont know what I am doing wrong... I do not eat cola, legumes,  chocolate, smoked or cured meats or any of the obvious stuff.  Are plain proteins high in phosphorus? I try to snack on fresh turkey breast, hard boiled egg, o boiled chicken breast because my albumin is low and I was told I need more protein.


As NoahVale has mentioned, DaVita has a good site about high and low phosphorus foods:

Some High Phosphorus Foods
Milk
Cheese
Yogurt
Ice Cream
Beer, Cola, Milk-based Coffee and Chocolate Drinks
Chocolate
Bran
Brown Rice, Wild Rice
Whole Grain Breads, Cereals & Crackers
Corn Tortillas
Pancakes, Waffles, Biscuits
Pizza
Avocado
Nuts, Seeds, Nut butters
Dried Beans & Peas
Corn & Peas
Processed Meats such as: Hot Dogs, Sausage, Turkey Sausage, Bologna
Organ Meats
Sardines

Note: The above list does not include all foods high in phosphorus. Portion size also plays a role in the amount of phosphorus you get from foods. Consult your dietitian and doctor to provide specific recommendations based on your individual needs.

Some Low Phosphorus Foods
Certain brands of Nondairy Creamers, Rice Milk (Unenriched), Soy Milks
Cream Cheese, Sour Cream
Soda-Lemon-lime, Grape, Strawberry, Cream Soda, Root Beer, Homemade Iced Tea, Homemade Lemonade, Hot Apple Cider, Cranberry Juice
Gelatin, PopsiclesŪ, Sherbet, Sorbet
Jellybeans, Fondant, Gumdrops, Hard Candy
Unsalted Popcorn or Pretzels
Sugar Cookies, Shortbread Cookies, Vanilla Wafers, Lemon Cake, White or Yellow Cake, Angel Food Cake
Jam, Jelly, Honey, Cream Cheese
Margarine, Butter
Corn or Rice Cereals, Refined Wheat Cereals
Cream of Wheat, Cream of Rice, Grits
French, Italian or White Bread
White Rice, Pasta, Couscous
Fresh or Fresh Frozen Meat, Fish and Poultry (compared to processed)
Fruits such as: Apples, Berries, Grapes, Plums, Pineapple, Canned Pears, Peaches, Fruit Cocktail
Vegetables such as: Green Beans, Cabbage, Carrots, Cauliflower, Eggplant, Summer Squash, Bell Pepper, Cucumber, Lettuce, Onion, Radish

Note: Even if food is considered low in phosphorus, portion size also plays a role in the amount of phosphorus you get from foods. Consult your dietitian and doctor to provide specific recommendations based on your individual needs.
Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
talker
Sr. Member
****
Offline Offline

Gender: Male
Posts: 530


Talkers oil painting

WWW
« Reply #14 on: April 06, 2014, 11:55:10 AM »

Although I am taking 3 Renvela tabs with meals and 2 with snacks, my phosphorus is still above 7.0. I dont know what I am doing wrong... I do not eat cola, legumes,  chocolate, smoked or cured meats or any of the obvious stuff.  Are plain proteins high in phosphorus? I try to snack on fresh turkeyy breast, hard boiled egg, o boiled chicken breast because my albumin is low and I was told I need more protein.

Phoslo disagreed with my body systems. Tums, as suggested for me, in place of Phoslo was against my using them, regardless of what I was being told.
Is hard to explain, but you may not be doing any thing wrong, just not enough things right.

So I started looking at the whole thing from my bodies point of view.
I felt there was an imbalance of vitamins and minerals.
So did start certain supplements. But and a big but, what worked for me may not work for anyone else.
For me it has worked out well. Another talker story yet untold.

talker
Logged

Be Well

"Wabi-sabi nurtures the authentic by acknowledging three simple realities: nothing lasts, nothing is finished, and nothing is perfect."

Don't ever give up hope, expect a miracle, pray as if you were going to die the next moment in time, but live life as if you were going to live forever."

A wise man once said, "Yesterday's the past, tomorrow's the future, but today is a gift. That's why it's called the present."
goofball
Jr. Member
**
Offline Offline

Gender: Female
Posts: 68


« Reply #15 on: April 06, 2014, 08:39:45 PM »



Most food packaging does not list phosphorus at all so I don't see how I can look at packaging.


Yes, phosphorous is listed on food packaging.  Read the listing of additives!  See my above post with words to look for on packaged foods.

We can tell if there are phosphates in the ingredients list... but the actual amounts are anyone's guess.  We can't tell if it's a lot or a little.
Logged

APKD - 47yr-old

Renal Diet Chef
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #16 on: April 06, 2014, 11:11:30 PM »

Have you noticed how most things low in phosphate are high in potassium ....
Can anyone create a list of low phosphate and low potassium foods???   :thumbdown;
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
ianch
Jr. Member
**
Offline Offline

Gender: Male
Posts: 95


WWW
« Reply #17 on: April 07, 2014, 01:47:25 AM »

Just do more dialysis hours and you can eat whatever you want. 

https://kiwimedtec.com/pub/rkf_calculator.php
Logged

Ian Chitty
ESRD suffer, IT specialist, and business owner
(<2yrs) 1Y in-center, 9 months HomeD, 4 weeks tourism dialysis (Philippines/Singapore)

https://kiwimedtec.com
The aim of KiwiMedTec is to develop online solutions and partnered networks for dialysis patients, to make coping with kidney disease a little bit easier.
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #18 on: April 07, 2014, 01:02:01 PM »

Just do more dialysis hours and you can eat whatever you want. 

https://kiwimedtec.com/pub/rkf_calculator.php

If only!!!!! In the Uk you get what you get given  :Kit n Stik;
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
goofball
Jr. Member
**
Offline Offline

Gender: Female
Posts: 68


« Reply #19 on: April 07, 2014, 03:05:03 PM »

Have you noticed how most things low in phosphate are high in potassium ....
Can anyone create a list of low phosphate and low potassium foods???   :thumbdown;

I've done it already!

http://ndb.nal.usda.gov/ndb/nutrients/report?nutrient1=24&nutrient2=25&nutrient3=26&fg=&max=25&subset=0&offset=7575&sort=c&totCount=7622&measureby=g
Logged

APKD - 47yr-old

Renal Diet Chef
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #20 on: April 08, 2014, 06:56:47 AM »

Have you noticed how most things low in phosphate are high in potassium ....
Can anyone create a list of low phosphate and low potassium foods???   :thumbdown;

I've done it already!

http://ndb.nal.usda.gov/ndb/nutrients/report?nutrient1=24&nutrient2=25&nutrient3=26&fg=&max=25&subset=0&offset=7575&sort=c&totCount=7622&measureby=g
Wow! I really need a shortened version of foods i can eat without raising my levels too high.
It's easier to identify what you can't eat than what you can!!!
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
goofball
Jr. Member
**
Offline Offline

Gender: Female
Posts: 68


« Reply #21 on: April 08, 2014, 09:46:18 AM »

Check out Napa cabbage!  It's delicious and super-low in both.

Egg whites are a fantastic source of low-P/low-K protein.
Logged

APKD - 47yr-old

Renal Diet Chef
Sugarlump
Elite Member
*****
Offline Offline

Gender: Female
Posts: 2160


10 years on and off dialysis

« Reply #22 on: April 09, 2014, 10:56:44 AM »

What is Nappa cabbage??? Do we have an english equivalent.
And of course I have to fatcor into the ocassion, Vitamin K content (particularly in green leafy veg), as am on warfarin!  :beer1;
Logged

10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
goofball
Jr. Member
**
Offline Offline

Gender: Female
Posts: 68


« Reply #23 on: April 10, 2014, 06:54:33 AM »

It's a big cabbage shaped like a torpedo.  It's sometimes called "celery cabbage" and "Chinese cabbage."

It has a very mild taste and an excellent texture.  It keeps for weeks in the fridge!

HOWEVER for you... it's moderate in vitamin K.
http://www.campbell.amedd.army.mil/pharmacy/Warfarin.pdf

45 mcg vitamin K per 100g Napa cabbage
« Last Edit: April 10, 2014, 07:02:25 AM by goofball » Logged

APKD - 47yr-old

Renal Diet Chef
noahvale
Guest
« Reply #24 on: April 10, 2014, 07:36:14 AM »

^
« Last Edit: September 19, 2015, 06:02:26 AM by noahvale » Logged
Pages: [1] 2 Go Up Print 
« previous next »
 

Powered by MySQL Powered by PHP SMF 2.0.17 | SMF © 2019, Simple Machines | Terms and Policies Valid XHTML 1.0! Valid CSS!