Phosphorus and Calcium

Controlling Phosphorus

Even with dialysis and a proper diet, most patients with chronic kidney disease need extra help controlling phosphorus in the body. Phosphate binders are taken with meals to help clear away the phosphorus that is found in food, before it can enter the blood. Like a sponge, phosphate binders soak up the phosphorus from the foods you eat.

Phosphorus and Calcium Balance

Like phosphorus, calcium is another important mineral that can become out of balance. Phosphorus and calcium are found in many foods such as milk, cheese, nuts and meat. When the kidneys are healthy, phosphorus and calcium work together to keep bones and teeth strong. But these two minerals often become unbalanced when the kidneys do not function properly. This imbalance can lead to calcification – extra phosphorus and calcium clump together to form hard calcium deposits in the body. When these deposits build up in places like the heart, arteries, joints and lungs they can cause the tissues to harden. At times this condition is hard to detect. It can occur quickly and may lead to serious health problems. Therefore, it is necessary to monitor phosphorus and calcium levels.

Managing Phosphorus and Calcium

Maintaining the right levels of phosphorus and calcium is an important way to reduce the risk of serious health consequences. That’s why it is important to:.

1. Attend and complete full dialysis treatment
Dialysis sessions help remove phosphorus. It is important to attend dialysis as prescribed, and to stay for the full dialysis session.

2. Follow a low phosphorus diet
Dietitians prescribe a diet low in phosphorus. It is important to follow this diet to limit the amount of phosphorus entering the body.

3. Take your phosphate binder as directed with each meal
Phosphate binders are effective at removing phosphorus from the foods you eat so the phosphorus does not get absorbed into the body. They must be taken with meals.

4. Know your goal!
The National Kidney Foundation’s Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease, recommend that patients with Chronic Kidney Disease on dialysis maintain phosphorus levels in the range of 3.5 – 5.5 mg/dL and that calcium levels be maintained in the range of 8.4 – 9.5 mg/dL. Patients should work with their healthcare team to keep their phosphorus and calcium levels within the target ranges.

5. Be aware of Calcium
Too much calcium can cause problems for patients with Chronic Kidney Disease on dialysis.

• Do not use Renagel if you have very low phosphorus levels or a history of bowel obstruction.
• Talk to your doctor if you have had digestive tract surgery, or other digestive disorders including severe constipation.
• The most common side effects with Renagel include vomiting, nausea, diarrhea, upset stomach, abdominal pain, constipation, and rash.
• In uncommon instances, patients have experienced bowel obstruction.
• Take Renagel with meals and adhere to your prescribed diet.
• Speak to your doctor when taking Renagel with other medications.
• Promptly contact your doctor if you experience severe abdominal pain, new or worsening constipation, or other severe intestinal symptoms while on Renagel.