Many dialysis patients are advised to eat a diet that is both low in phosphates and high in protein. In practice, however, this is not so easy. The phosphorus-protein quotient (PPR) can help. Here you can find out what the PPR is for, what you should look out for and which foods are recommended according to the PPR.
Why is the ratio of phosphorus to protein important for people on dialysis?
As you probably already know, a sufficient supply of protein is very important after the start of dialysis treatment. The reasoning behind this is mainly to avoid malnutrition and to counteract the increased loss of amino acids via dialysis. At the same time, however, you should make sure that your diet is low in phosphates. This could reduce secondary diseases of reduced kidney function such as bone changes and arteriosclerosis.
However, since many protein-rich foods are also rich in phosphate, there is a risk that you will eat a diet rich in protein but also rich in phosphate. For dialysis patients, the ratio of phosphate to protein is therefore significant. The phosphorus-protein ratio (PPR) is therefore a good tool for everyday life with dialysis. It helps you to recognize foods that contain a high amount of protein and yet little phosphate.
How is the phosphorus-protein ratio (PPR) calculated?
As you might have guessed, the PPR describes the ratio of milligrams of phosphorus to grams of protein in a particular food item. If your dialysis team recommends that you eat a high-protein, low-phosphate diet, you should try to follow a diet that is full of foods with lower PPR. In such a case, the lower the PPQ, the better. Typically, foods with PPQ values below 15 are recommended.
Where can I find the phosphorus-protein ratio (PPR) in the Mizu app?
The Mizu app helps you because it allows you to identify recipes and foods with a favorable phosphorus to protein ratio. It calculates the PPR for you for thousands of foods and hundreds of recipes. Do you want to know the PPR of, say, flaxseed or spaghetti bolognese? No problem. Just search for the food in question in the nutrition section of the app. In the detailed overview, you'll find all the important information and nutritional values, including PPR.
What is a good/bad phosphorus to protein ratio?
For many dialysis patients, the lower the phosphate content and the higher the protein content, the better. If this is also the case for you, protein-rich foods with a PPR below 15 are particularly recommended. High-protein foods with a PPR above 30 should be considered as having a high PPR value.
Also note: if a food is low in protein, then the PPR is not very meaningful. For example, an apple has a PPR of 32, which is relatively high. In practice, however, it doesn't matter because, like many other fruits and vegetables, it contains virtually no protein.
What are examples of foods with a good phosphorus-protein ratio?
In principle, you should keep in mind that in your overall diet it is not so important and often not good to completely avoid a number of foods. The balance is the most important thing! Together with your nutritionist or nephrologist you should find an individual diet that manages to keep your blood values in green areas. This is much more important and certainly more fun in everyday life than complete abstinence.
In general, here are some examples of certain food groups with a favorable PPR:
- Meat: beef tenderloin, duck, chicken, turkey, pork, mutton.
- Sausage: salami, mortadella, pancetta, corned beef, cooked ham
- Cheese/dairy products: Cream cheese, cottage cheese, Brie, Camembert, Limburger, Harzer cheese, low-fat curd cheese, Edam cheese
- Other: tofu, egg white, soy milk
What does the phosphorus-protein quotient say for foods with little protein?
As already mentioned, the PPR is not very meaningful for foods with little protein. For example, many fruits and vegetables, as well as beverages, pasta or rice, contain relatively little to almost no protein. As a result, low-protein foods would be considered rather bad purely on the basis of PPR. In reality, however, this is not true for dialysis patients. It's just because in the calculation low protein is relative to almost no protein.
What does that mean for you in practice? Never look at the PPR alone. It is always best to briefly check how much protein and phosphate are contained in a food. If these two values are low, then the PPR is less relevant when adapting your diet to your individual needs.
How does the PPR help me in my daily life with dialysis?
As you can see, the PPR in the Mizu app is a handy tool for finding dialysis-friendly foods. The PPR helps you quickly check whether a high protein food is suitable for you.
In combination with phosphate points, you will be able to keep your blood phosphate well under control with the PPR. You can also find a lot of practical information about this in the Mizu app.
