At what levels will Phosphorus start affecting you?

[iolaire]

I'm wondering at what level you will start feeling excess Phosphorus?  For example DaVita wants you to stay within 3.0 to 5.5 mg/dL of Phosphorus.  Is 10 mg/dL something people would feel, or 8 or 20? 

(I've been creeping up this month and am now at 6.4 MG/DL, but I expect it to fall as I make sure I don't miss binders.)

[Simon Dog]

I don't think it is a matter of "feeling" the higher level, but long term bone strength and health.

[talker]

I'm wondering at what level you will start feeling excess Phosphorus?  For example DaVita wants you to stay within 3.0 to 5.5 mg/dL of Phosphorus.  Is 10 mg/dL something people would feel, or 8 or 20? 

(I've been creeping up this month and am now at 6.4 MG/DL, but I expect it to fall as I make sure I don't miss binders.)

I don't think it is a matter of "feeling" the higher level, but long term bone strength and health.

We do need some Phosphorus to help ones heart to have a strong heart beat. Not able to find the saved article I wanted, but did find this one.
As with all minerals, we do walk a fine line, between 'balance' and disastrous results , adhering to the dialysis guide lines.

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Phosphorus and Heart Function
 
Phosphorus' mere involvement in all energy production makes it an indispensable partner to your heart since, like all organs, your heart needs energy in order to function. Also, phosphorus helps regulate blood calcium, and your heart depends on calcium for proper function. Additionally, blood acidity affects your heart rate. Phosphorus acts as a buffer to help maintain normal acid-base balance. It is also a phosphorus-containing compound named 2,3-DPG that helps red blood cells deliver oxygen to your body's tissues, including heart tissue.

Phosphorus and Heart Disease
 
In a 2007 landmark research effort called the Framingham Heart Study, Dr, Ravi Dhingra and colleagues showed that high levels of blood phosphorus increase heart disease risk. One reason this can happen is that elevated phosphorus levels reduce your body's ability to make vitamin D, which in turn leads to calcification in your heart's blood vessels. A second possibility is that high blood phosphorus directly causes mineral buildup in blood vessels, leading to blockage and heart problems. High phosphorus levels might also promote heart disease by triggering a hormone called parathyroid hormone, which puts the body in a state of inflammation.

[iolaire]

I don't think it is a matter of "feeling" the higher level, but long term bone strength and health.

I thought that phosphorus was the cause of itchy legs?

[PatDowns]

I thought that phosphorus was the cause of itchy legs?

Not limited to just the legs.  You might be getting restless leg syndrome (main causation - not enough/inadequate dialysis) confused with phos/calcium imbalance.   High phos can have immediate as well as long term effects on the body - mainly with the bones and heart, and having the parathyroid glands removed. Without reinventing the wheel, here's an excellent article on phosphorous and kidney failure from Davita's web site (they provide much better on-line info than quality of care treatment).

http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/phosphorus-and-chronic-kidney-disease/e/5306

My nephrologist prefers seeing monthly bloodwork level between 3.5-4.3 with a corresponding calcium level of 9.4-9.9.   I use Fosrenol as a binder because it's chewable and I don't have to waste fluids on taking it.  I keep a bottle on my desk and in a pill box small enough to keep in my pants pocket when knowing I'll be away for meals.   I get the 1000 mg. size because it is more economical.  For most meals 500 mg, does me well and I'll just bite off half a pill, even smaller with a big snack.

Bottom line, this is one area where you don't need to be challenging yourself.   Get in the habit of taking your binders.

Take care - PatDownsII

[Maggie and Jeff]

Maggie has been taken off binders since starting 8 hour nocturnal treatments 6x/week.

We are repulling labs due to a result of 1.9

Her potassium came back low also 3.4

We think it was too close to Christmas and something happen to the sample.

Last month

Phos 3.7
Potassium 4.0

The kt/v jumped from a fairly steady 2.6 to 3.1 on the last draw.
I just don't believe the kt/v jumped that much.

Maggie had a 3.0 kt/v for a few years when we moved to 8/h treatments the dosing calculator said we would need 25L of dialyzate to keep 3.0.
We are still using 20L to be sure her numbers don't drop to low.
And it sure looks like that may have happened..............only time will tell.




Now I want ya'll to know we spent years dealing with roller coaster phos and potassium levels high one month and low the next.

Take the binders if you need them

That reminds me of this just before starting the 8/h treatments and the later stopping of the binders.

A review of a local restaurant for tourists in a 3 stop sign town. 
(At a place I had been to hundreds of times over over the last 20 years.)

"My wife must take phosphorus binders any time she eats because her kidneys don't work any more. So the staff seen her horse sized pills and called the cops. My fried pickles were burnt and my hamburger was cold. Then we were detained as we left. No apologizes were given. I will never go back there. The crazy part is we have been in there many times the over years and have talked to the lady who usually runs the register about dialysis and the big pills. I guess she forgot. Anyway, that same lady was waiting outside to hear what we said to the cop and then acted odd when I opened the door for her as she headed inside. As if I would hurt her or some thing. Some tell me I should sue for slander. I would avoid this place if you ride a motorcycle like I do."

Visited April 2015

Cop was nice he just talked to us.
He said we should have the prescription bottle with us to which we replied "She is proscribed 5 pills per meal the bottle is huge and not practical to carry to the restaurant and it has never been an issue anywhere else".  "You should have the script your no longer being detained" said he ........... or something like that.


Hyperphosphatemia (High Phosphate)
http://chemocare.com/chemotherapy/side-effects/hyperphosphatemia-high-phosphate.aspx

 When to call your doctor or health care provider:

Severe constipation, unrelieved by laxatives, lasting 2 to 3 days.
Nausea that interferes with your ability to eat, and is unrelieved by any prescribed
medications.
Vomiting (vomiting more than 4-5 times in a 24 hour period).
Diarrhea (4-6 episodes in a 24-hour period), unrelieved with taking anti-diarrhea medication and diet modification.

[iolaire]

Thanks everyone. I've put some binders in a small envelope to keep near my keys so I start carrying them everywhere.  Have the binders in my desk at work, at home and in the car still means I head out without sticking them in my pocket and I sit down to an out meal without them - which seems to be no longer working.