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Reduced phosphate intake is important for almost all dialysis patients. Phosphate points are an aid for keeping the phosphate intake in your diet under control. Here you can find out what phosphate points are and how they can help you in your daily life with dialysis.
Here's what you need to know
Das solltest du wissen
Ecco cosa c'è da sapere
Voici ce qu'il faut savoir
Esto es lo que debe saber
  • Phosphate points (PhP) give you an orientation about the phosphate content of a food and could help you when taking your phosphate binders

  • They are graded: 0-50 mg = 0 PhP, 50-100 mg = 1 PhP, 100-200 mg = 2 PhP, 200-300 mg = 3 PhP, etc.

  • The ideal dosage of your phosphate binders should be determined by your nephrologist

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Why is reducing phosphate intake so important for many dialysis patients?

Your dialysis team may regularly remind you to eat as few phosphate-rich foods as possible and to make sure you take your phosphate binders regularly. Yep, we know…the constant reminders can be quite annoying at times. But why is reducing phosphate intake actually so important in kidney disease?

Reducing phosphate intake in dialysis patients is important because it counteracts the risk of (serious) secondary diseases. When the kidneys no longer work properly, the regulation of your phosphate balance also no longer functions properly. Phosphate is also partially removed during dialysis, but not nearly enough. In the long term, this can result in diseases such as osteoporosis and arteriosclerosis, which in extreme cases can lead to a heart attack or stroke. Increasing calcification of the pelvic blood vessels can even make it difficult to connect a transplant kidney.

How much phosphate can I take daily?

As a general guideline for dialyzers, it is recommended to adjust the phosphate level in the blood towards the reference range. You can also orient yourself to a daily intake of 800 to 1,000 mg of phosphate per day. However, it must be said that the daily amount of phosphate intake must be coordinated individually with your nephrologist. Once you have determined your individual daily guideline, you can enter it in your Mizu app. The app is the ideal helper to help you adhere to this guideline accordingly.

What are phosphate points and how are they calculated?

Phosphate points (PhP), also called phosphate units, are a guide to help you understand more quickly how much phosphate is in a particular food. The logic is as follows: for every 100 mg of phosphate, 1 phosphate point is calculated. So the higher the phosphate content of a food, the higher the assigned phosphate points.

If the phosphate content is only between 0-50 mg, 0 phosphate points (PhP) are credited. Foods containing 50-100 mg provide 1 PhP, from 100-200 mg it is 2 PhP, from 200-300 mg it is then 3 PhP, etc. For meals or dishes, the phosphate content is calculated by adding the phosphate points of each food.

Also note: three foods with a PhP count of 0 (excluding sugar, fat, and water) per meal are also counted as 1 PhP. But don't worry, the Mizu app does all these calculations for you.

What are phosphate points for?

Besides guiding you about the phosphate content in a food, PhP could help you especially with the dosage of your phosphate binders. Your nephrologist will probably recommend that you adjust your phosphate binders to your phosphate intake.

The ideal ratio of phosphate binders to PhP is probably individual, as people absorb phosphate differently. You will need to determine what the best ratio is for you with the help of your medical team. Once you know that, the Mizu app can help you with the right dosage: for example, if the ratio is 3:1 and your meal contains 9 phosphate points, in this case you would take three tablets before or with a meal. However, the dosage of your medication is clearly a matter for your treating nephrologist. Unfortunately, the Mizu app cannot and should not help you here, because nothing replaces the advice of your doctor.

How do I know which foods contain how much phosphate?

The Mizu app can help you with this in your everyday life. You can look up individual foods and recipes, as well as calculate the total amount of phosphate using the food diary.

Please note that the Mizu app has typical portion sizes stored. However, the app cannot know how much you actually eat. You should always check the portion sizes and adjust them accordingly in case of deviations.

Medically reviewed by:
Medizinisch überprüft durch:
Verificato dal punto di vista medico da:
Médicalement vérifié par :
Médicamente comprobado por:
Dr. Diego Parada Rodriguez (en)
Specialist in training for Nephrology
References
References
References
References
References
  • Kuhlmann, M., Landthaler, I., Höchst, S. (2005). PEP – Das Phosphat-Einheiten-Programm. Ernährungs-Umschau, 52 (4), 152-154.
  • Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2017 Jul;7(1):1-59. doi: 10.1016/j.kisu.2017.04.001. Epub 2017 Jun 21. Erratum in: Kidney Int Suppl (2011). 2017 Dec;7(3):e1. PMID: 30675420; PMCID: PMC6340919.
  • Isakova T, Nickolas TL, Denburg M, Yarlagadda S, Weiner DE, Gutiérrez OM, Bansal V, Rosas SE, Nigwekar S, Yee J, Kramer H. KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Am J Kidney Dis. 2017 Dec;70(6):737-751. doi: 10.1053/j.ajkd.2017.07.019. Epub 2017 Sep 21. PMID: 28941764.
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