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Patient Leaflet

Low Phosphate Diet

Information on a low phosphate diet for people with kidney disease.

Classification: DT (Dietitian) Advice is complex, condition specific and requires a Dietitian with knowledge, skills and experience in the condition.


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  • To support the dietary education for long-term condition management of people with chronic kidney disease and requiring a low phosphate diet. The target group will:

    • understand that they need to follow a low phosphate diet due to their kidney disease
    • know the risks associatied with high blood serum phosphate levels
    • know their blood serum phosphate target range
    • know that phosphate binders are/ may be needed to achieve their taget blood serum phosphate level
    • know that phosphate binders must be taken with foods containing phosphate if they are to be effective
    • be able to identify foods high in phosphate and suitable lower phosphate alternative foods
    • be aware of the impact of additives on controlling phosphate levels
    • be aware of the benefits of cooking from scratch without processed foods
    • be able to plan and follow a low phosphate diet to achieve their blood serum target range

    Evidence Base:

    • European Guidelines for the Nutritional Care of Adult Renal Patients (EDTNA) 2003.
    • McCance and Widdowson’s Composition of Foods Integrated dataset (CoDID, 2015 accessed from https://www.gov.uk/government/publications/composition-of-foods-integrated-dataset-cofid).
    • Fouque D. et al (2007). European Best Practice Guideline on Nutrition. Nephrology Dialysis Transplantation, Volume 22, Issue suppl_2
    • NICE (2013) Hyperphosphataemia in chronic kidney disease: Management of hyperphosphataemia in patients with stage 4 or 5 chronic kidney disease. Clinical guideline 157.
    • Kalantar-Zadeh K., Gutekunst L., Mehrotra R., Kovesdy C.P., Bross R., Shinaberger C.S., Noori N., Hirschberg R., Benner D., Nissenson A.R. and Kopple J.D. (2010) Understanding Sources of Dietary Phosphorus in the Treatment of Patients with Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 5, pp. 519-530.
    • National Kidney Federation. (2009) KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney International,113, pp.S1-130.
    • Christian S Shinaberger (2008). Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? The American Journal of Clinical Nutrition, Volume 88, Issue 6, 1 December 2008, Pages 1511–1518
    • British Dietetic Association (2013). Renal Nutrition Specialist Group – low phosphate diet rationale. www.bda.uk.com/regionsgroups/groups/renal/groupresources/lowphosphatedietrationale
    • Schlemmer et al (2009). Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol. Nutr. Food Res. 2009, 53, S330 –S375
    • Hannah J et al (2017). Phosphorus in food: new insights and recommendations for practice. Journal of Kidney Care, vol 2 no 3 p 66-72.
    • NHS 5-a-day portion sizes. https://www.nhs.uk/live-well/eat-well/5-a-day-portion-sizes/ (Accessed 2019).
  • Publication Details

    NDR-UK Ref No:

    9473

    Publication Format:

    A5 leaflet

    Classification:

    DT

    Pack size:

    10

    Publication date:

    2019

    Last Review:

    2019

    Next Review:

    2022