Binders question

[Brightsky69]

I am sure this has been asked before. I just couldn't find the answer.

If I take my binders does that bind ALL the phosphorous in my foods or just some of the phosphorous?
If I eat a nice big baked potato and take my binders will that take care of all the phosphorus or just part of it?

[Rerun]

Potatoes have potassium.  High phos foods are like dairy and breads.

I have asked the question "how much Phosphorus does one pill soak up"?  They can't tell me.  It is a guessing game.  Just take a couple before you take your first bite with meals.  Take one with snacks.  Watch your lab work.  If your Phos is still high take 3 with meals and 2 with snacks.

Learn your high phos foods and take 1 more binder if you are having a hamburger with cheese.

Potassium is harder to watch since there is no binder for that.  They could put you on a 1k bath which would take out more Potassium but they won't. 

If you are on hemodialysis check to see what potassium bath you are on.  If it is 3k and your potassium is always high ask you doc if you need a 2k.  It takes out more potassium (or K).

Hope this helps.   

[jbeany]

Everyone's body chemistry is different, so it's hard to tell.  No, it won't likely bind all the phos you eat.  You can use too many binders, though, and drop your phos too far.  I adjust my binder amount according to the meal I'm eating and how much phos it has.  A whole binder for a sandwich with cheese and meat, a half binder for something lower, like fruit and a cookie, etc.  And yes, if you are going to eat something really over the top - a double cheeseburger, or something Mexican smothered in cheese, take extra binders!  Rerun's got it - watch your labs and adjust accordingly.

[RichardMEL]

I agree with the gals. If I'm having something that's extra high in phos (cheese mainly) then I throw another binder in the mix. This keeps my phos in the normal range.. even sometimes a bit low of normal but not under or anything. I checked with the neph and he was fine with that solution specially so it means I feel less guilty about eating a double cheeseburger.... YUM!

 

[kristina]

I have never come across "Binders", could someone please tell me
why you take them and what they are for?
Thank you.

[peleroja]

Other high phosphorus foods: coffee, dark soft drinks, nuts.

kristina, binders such as Phoslo, Renagel, Renvela, even Tums, are taken with meals and snacks to remove excess phosphorus from the body, as dialysis does not remove it.

[joyfulmother]

How did I not know that coffee was high is phosphorus?  Tell me it isn't so.

[Zach]

Other high phosphorus foods: coffee, dark soft drinks, nuts.

Coffee is not high in phosphorus.

Coffee, brewed from grounds, prepared with tap water:
8 fl oz.
Phosphorus, P     7 mg
Potassium, K   116 mg

For more information, go to this link to the USDA National Nutrient Database.
http://www.nal.usda.gov/fnic/foodcomp/search/
 
And the illustration below shows where in the gastrointestinal track the phosphorus is absorbed.

[kristina]

Other high phosphorus foods: coffee, dark soft drinks, nuts.

kristina, binders such as Phoslo, Renagel, Renvela, even Tums, are taken with meals and snacks to remove excess phosphorus from the body, as dialysis does not remove it.

Thanks very much for answering, peleroja, may I please ask another question.
Is a binder something one would take in end-stage-renal-failure before dialysis
or is it taken when on dialysis?
Or, to put it another way, is a binder taken by anyone
who has high levels of phosphate (phosphorus)
to allow Vitamin D to work and to protect the bones etc.?
I am not medical, I am just trying to put it together
to understand it all.
Thank you.

[Restorer]

A thread with some good information on binder effectiveness: http://ihatedialysis.com/forum/index.php?topic=11307.0

[kristina]

Thank you Restorer,
for the information,
it is very much appreciated.
Thanks again. Kristina.

[RichardMEL]

I was started on phosphate binders (back then it was alutabs) before I started dialysis. I think my phos was a bit high and the neph wanted to get that under control. The levels changed a bit when I started dialysis just to keep everything in order and last year I moved to Renagel which is MUCH better(for me) and works a treat. No issues whatsoever with the binders.

Binders - it is VERY important to take with the food.. if you take >30 mins later there's no point as the phos is absorbed already. Some people don't always remember to take them.

[cariad]

Wow, I've been doing this wrong for quite some time!

It makes perfect sense that it would only work when taken with food, but of course I rarely remember to take them until after I've eaten, and sometimes not until just before bed.  Since my phosphorous is never high, even with my cheese and whole grain based diet, I am beginning to suspect that I should not bother taking this med for now.

Thanks for the great link, Zach! I have been wondering about some of the more obscure foods I eat, like cherimoya. It looks to be fairly renal friendly! Hurrah!

[petey]

Binders, binders, binders...they are everywhere in our house, in my car, in Marvin's car, a small bottle in my pocketbook, a small container in his pocket, another bottle in my best friend's pocketbook (hey, you never know when Marvin will need them).  Marvin's pretty good about taking them, but then I constantly remind him, too.  I think this is probably the most important medication he takes now (since he came off all the bp meds when he went on home hemo). 

[YLGuy]

Binders, binders, binders...they are everywhere in our house, in my car, in Marvin's car, a small bottle in my pocketbook, a small container in his pocket, another bottle in my best friend's pocketbook (hey, you never know when Marvin will need them).  Marvin's pretty good about taking them, but then I constantly remind him, too.  I think this is probably the most important medication he takes now (since he came off all the bp meds when he went on home hemo).

How many pills is the prescription written for?

[petey]

Marvin takes Fosrenol now (has taken PhosLo and Renagel in the past).  His bottles have 45 tablets each, and his prescription calls for four bottles to be filled at the time.  Of course, he takes 3 tablets with every meal and 2 with every snack.  Marvin usually takes 11 - 13 tablets in an average day, so this prescription lasts him about 15 days before it has to be filled again.  (Don't tell anybody, but Marvin's first dialysis nurse from 14 years ago has stayed in contact with us -- she's now a regional supervisor over a four-county area of clinics.  She's one of our good friends, and she often brings him lots of "samples" of Fosrenol from her clinics.)

[RichardMEL]

My doctor has been pretty good about this. I take Renagel - one with meals/snacks (two if it's a phos heavy item with lots of cheese or something - or if I'm being naughty and drinking a coke ) but the neph writes the script for 2 tabs 3x/day(ie: 2 with each meal) so I get like 180 in a bottle and that lasts for awhile. I have one bottle at work and one at home - so if I forget I always have some nearby.

I do agree that the binders is the most time sensitive (in relation to having food) med we have and it's important to take them properly.

It is an easy thing to forget though but I only forget a couple of times a month i think so it's not too bad, and my P levels are usually very good.