Kidney and bladder health

15 June 2010

Renal nutrition: phosphate

Phosphate recommendations for chronic renal failure patients, provide by the Nutrition Information Centre of the University of Stellenbosch (NICUS).

 Phosphate is a mineral found in food and is essential for healthy bone formation. It is the second most abundant mineral in the body, representing 1% of the total adult body weight or 25% of the total mineral content of the adult body.

During kidney failure, the kidneys cannot excrete phosphate sufficiently and it accumulates in the blood. This causes calcium to leak from the bones, and leads to weak bones that are more likely to break. It may even damage the kidneys, other organs, and may cause the skin to itch. For these reasons, patients with chronic renal failure must restrict the intake of phosphate through the diet.

Phosphate is widely distributed in food - generally good sources of protein are also good sources of phosphate. Dairy products and animal products like meat, poultry, fish and eggs contribute 60% of dietary phosphate in a mixed diet. Cereals and legumes contribute another 20% of dietary phosphate in a mixed diet. 

Whole grains and whole grain flour contain phosphate in the form of phytate or phytic acid, which form insoluble compounds with other minerals in the diet like calcium, iron and zinc, thus reducing their absorption. Vegetables and fruit contribute about 10% of dietary phosphate in a mixed diet.Phosphate food additives are widely used by the food industry in baked goods, cheeses, processed meats and cold drinks. 

  • Milk, cheese and egg

  • High phosphate meat and meat alternatives

  • Meat and / or vegetable extracts

  • Cereals

  • Sweets

  • Restrict milk intake to 1 portion (½ cup) per day.
  • Restrict high phosphate meats to 1 portion or 30g (matchbox size) per day and rather eat more of the low phosphate foods as prescribed by the dietician.
  • Avoid or limit processed meat and dark cold drinks.
  • Medication used to bind phosphate from the diet so that it is excreted in the stool, has to be taken with meals and not between meals.


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