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Healthy tips for a low phosphorus 
Check the nutrition label 
Nutrition Facts 
Serving Size: 1 Cookie (52g) 
Serving Per Container: 24 
Amount Per Serving 
Calories 220 Calories from Fat 80 
% Daily Value* 
Total Fat 9g 13% 
Saturated Fat 5g 25% 
Trans Fat 0g 
Cholesterol 35mg 11% 
Sodium 160mg 6% 
Potassium 70mg 2% 
Total Carbohydrate 
10% 
32g 
Diatary Fiber 1g 4% 
Sugars 17g 
Protein 3g 
Vitamin A 6% Vitamin C 0% 
Calcium 2% Iron 4% 
Phosphorus 10% 
*Percent Daily Values are based on a 2,000 calorie diet. 
Check the ingredients 
A lot of phosphorus in food & drinks is hidden in additives. 
Be on the look out for any ingredients containing the 
letters PHOS. For example: 
Phosphoric acid Sodium polyphosphate 
Also look out for foods that are fortified with calcium as 
these may also contain high levels of phosphorus. 
Can you spot the phosphorus hiding in this 
ingredients list? 
Ingredients: Whole Grain Wheat, Corn Bran, Corn Starch, Sugar, 
Corn Syrup, Wheat Bits (whole grain wheat, salt, sugar, sodium 
tripolyphosphate), Cinammon, Vitamin E, Phosphoric Acid, 
Potassium Hydroxide, Hexametaphosphate, Sodium Selanate 
HINT: There are 3 phosphate additives to find. Answer can be found below. 
For example: 1 Cookie (52g) 
In general, as a % of daily value: 
High >10% – Might be best to avoid 
Medium 5-10% – Be careful with portion size 
Low <5% – Check portion size 
Make simple changes in your food & drink choices 
Find references online: www.compact-renal.com/service-center/patient-material/ 
Answer: sodium tripolyPHOSphate, PHOSphoric Acid, HexametaPHOSphate 
Pale fizzy drinks, 
fruit juice instead of 
Coca-Cola, ale, beer 
Chicken or fish 
instead of red meat 
Rice milk or soy milk 
instead of milk 
Black coffee or tea 
instead of hot chocolate 
Corn or rice cereals 
instead of bran, oat or 
wheat cereals 
Sorbet instead of 
ice-cream 
Cream cheese or 
sour cream 
instead of cheese 
Green beans, couscous or 
popcorn instead of 
dried beans, peas or nuts 
Sweets 
(BUT check additives) 
instead of chocolate 
Jam, honey or butter 
instead of peanut butter 
White bread 
instead of whole 
grain bread 
Fresh food instead of 
processed food 
Serving size & servings per container 
tell you how big a portion should be. 
Switching to alternatives can help you stay healthy 
Patient material 
Your dietitian can help you design a 
diet that keeps you healthy and that 
includes food and drink which you 
can both enjoy and afford. ! 
COMPACT Renal 
Comprehensive treatment of hyperphosphatemia
COMPACT Renal 
Comprehensive treatment of hyperphosphatemia 
tips to help you with your 
phosphate binders 
? 
Don’t be afraid to 
ask questions 
Make sure you are clear how many binders you need 
to take and when you should take them. Write it down! 
Also ask your doctor about any concerns you have 
regarding your medication. 
For example: 
> Why do I need to take phosphate binders? 
> How should I expect to feel the first few times 
I take them? 
> How do I know if phosphate binders are working for me? 
Patient material 
Keep your 
schedule simple 
Make a list of AL the medications you need to take and 
when you need to take them. 
> Can you simplify the list? Maybe you can combine times when 
you take your medicine, e.g. taking “morning” medicines with 
breakfast? 
> Consider getting a pill box! 
> Check your medication list with your pharmacist or doctor. 
Set up reminders 
Use mobile phone alarms or sign up for 
text messages that alert you when to take 
your medication! 
Many websites can offer further tips, advice and 
support, such as www.scriptyourfuture.org. 
Stick with 
your medication 
Phosphate binders won’t make you feel better right after you 
take them. You might feel that you can skip a few tablets, or 
a week of tablets, and it won’t make much difference. 
But, over time, high levels of phosphorus can lead to heart 
attacks, strokes or a stay in hospital with bone fractures. 
So make a pledge to yourself that you will stick 
with your medication! 
If it´s not working out, ask for help 
There are always other options that you can try (maybe a different tablet, a different dose or a new 
schedule) so, in order to stay as healthy as possible, always ask for help and don’t just stop taking 
your medication. 
Find references online: www.compact-renal.com/service-center/patient-material/
CMOPACT Renal Patient material 
Comprehensive treatment of hyperphosphatemia 
Why is it important to control 
your phosphate levels? 
If your kidneys aren’t functioning properly, phosphorus 
can build up in your blood, leading to hyperphosphatemia 
(high phosphorus levels). 
High phosphorus levels might not cause any symptoms today... …but they store up problems for tomorrow 
Bone disease & fractures Heart disease 
High phosphate pulls 
calcium from your bones. 
Dialysis, diet & medication all help to 
control phosphorus levels 
Dialysis alone cannot control phosphorus levels, which is why 
doctors also recommend that you follow a well-planned diet and 
can prescribe you phosphate binder tablets as well. 
A low phosphorus diet helps to reduce your phosphate levels. 
Phosphate binder tablets act in stomach and gut binding phosphorus 
before it is taken into blood circulation. 
The extra calcium from your 
bones can end up in your 
arteries & heart. 
This can make your bones weak and 
more likely to break. 
This can lead to heart complications, 
such as heart attack or stroke. 
P 
P 
P P 
P 
Ca 
Ca 
Ca 
P 
P 
Find references online: www.compact-renal.com/service-center/patient-material/
COMPACT Renal 
Comprehensive treatment of hyperphosphatemia references 
Healthy tips for low phosphorus 
Check the nutrition label > phosphorus low/medium/high ratio: 
Your guide to the new food label: http://www.kidney.org/atoz/content/foodlabel 
Check the ingredients > link between calcium fortification & high P: 
Cerklewski, Florian L. “Calcium fortification of food can add unneeded dietary phosphorus.” Journal of Food Composition and Analysis 
18.6 (2005): 595-598. 
Swap food & drink choices 
Multiple sources, including: 
> Phosphorus in Foods: What to Know When You‘re on a Kidney Diet: http://www.davita.com/kidney-disease/diet-and-nutrition/ 
diet-basics/phosphorus-in-foods:-what-to-know-when-you%27re-on-a-kidney-diet/e/10253 
> NKF/Fresenius patient materials 
> USDA nutrient database 
> Low-phosphorus diet: Best for kidney disease? http://www.mayoclinic.org/food-and-nutrition/expert-answers/faq-20058408 
> Phosphorus and your CKD diet: http://www.kidney.org/atoz/content/phosphorus 
Tips to help with binders 
FDA Consumer Update: 
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm164616.htm 
CDC Medication Adherence advice (to providers): 
http://www.cdc.gov/primarycare/materials/medication/docs/medication-adherence-01ccd.pdf 
NICE Guidance (to providers) for improving adherence: 
http://www.nice.org.uk/guidance/cg76/chapter/1-guidance 
Why is it important to control P? 
P build-up in bloodstream 
Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998; 32:S112. 
Pulling calcium from bones 
Goltzman, David. “5 Parathyroid Hormone: Its Role in Calcium and Phosphate Homeostasis.” The Physiological Basis of 
Metabolic Bone Disease (2014): 103. 
Heart complications 
Hruska, Keith A., et al. “Hyperphosphatemia of chronic kidney disease.” Kidney International 74.2 (2008): 148-157. 
Shanahan, Catherine M., et al. “Arterial calcification in chronic kidney disease: key roles for calcium and phosphate.” 
Circulation research 109.6 (2011): 697-711. 
Treatment options 
Fouque D, Horne R, Cozzolino M, Kalantar-Zadeh K. Balancing nutrition and serum phosphorus in maintenance dialysis. 
Am. J. Kidney Dis. 2014;64(1):143-150. doi:10.1053/j.ajkd.2014.01.429.

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Test comp act_renal_report_june_2014

  • 1. Healthy tips for a low phosphorus Check the nutrition label Nutrition Facts Serving Size: 1 Cookie (52g) Serving Per Container: 24 Amount Per Serving Calories 220 Calories from Fat 80 % Daily Value* Total Fat 9g 13% Saturated Fat 5g 25% Trans Fat 0g Cholesterol 35mg 11% Sodium 160mg 6% Potassium 70mg 2% Total Carbohydrate 10% 32g Diatary Fiber 1g 4% Sugars 17g Protein 3g Vitamin A 6% Vitamin C 0% Calcium 2% Iron 4% Phosphorus 10% *Percent Daily Values are based on a 2,000 calorie diet. Check the ingredients A lot of phosphorus in food & drinks is hidden in additives. Be on the look out for any ingredients containing the letters PHOS. For example: Phosphoric acid Sodium polyphosphate Also look out for foods that are fortified with calcium as these may also contain high levels of phosphorus. Can you spot the phosphorus hiding in this ingredients list? Ingredients: Whole Grain Wheat, Corn Bran, Corn Starch, Sugar, Corn Syrup, Wheat Bits (whole grain wheat, salt, sugar, sodium tripolyphosphate), Cinammon, Vitamin E, Phosphoric Acid, Potassium Hydroxide, Hexametaphosphate, Sodium Selanate HINT: There are 3 phosphate additives to find. Answer can be found below. For example: 1 Cookie (52g) In general, as a % of daily value: High >10% – Might be best to avoid Medium 5-10% – Be careful with portion size Low <5% – Check portion size Make simple changes in your food & drink choices Find references online: www.compact-renal.com/service-center/patient-material/ Answer: sodium tripolyPHOSphate, PHOSphoric Acid, HexametaPHOSphate Pale fizzy drinks, fruit juice instead of Coca-Cola, ale, beer Chicken or fish instead of red meat Rice milk or soy milk instead of milk Black coffee or tea instead of hot chocolate Corn or rice cereals instead of bran, oat or wheat cereals Sorbet instead of ice-cream Cream cheese or sour cream instead of cheese Green beans, couscous or popcorn instead of dried beans, peas or nuts Sweets (BUT check additives) instead of chocolate Jam, honey or butter instead of peanut butter White bread instead of whole grain bread Fresh food instead of processed food Serving size & servings per container tell you how big a portion should be. Switching to alternatives can help you stay healthy Patient material Your dietitian can help you design a diet that keeps you healthy and that includes food and drink which you can both enjoy and afford. ! COMPACT Renal Comprehensive treatment of hyperphosphatemia
  • 2. COMPACT Renal Comprehensive treatment of hyperphosphatemia tips to help you with your phosphate binders ? Don’t be afraid to ask questions Make sure you are clear how many binders you need to take and when you should take them. Write it down! Also ask your doctor about any concerns you have regarding your medication. For example: > Why do I need to take phosphate binders? > How should I expect to feel the first few times I take them? > How do I know if phosphate binders are working for me? Patient material Keep your schedule simple Make a list of AL the medications you need to take and when you need to take them. > Can you simplify the list? Maybe you can combine times when you take your medicine, e.g. taking “morning” medicines with breakfast? > Consider getting a pill box! > Check your medication list with your pharmacist or doctor. Set up reminders Use mobile phone alarms or sign up for text messages that alert you when to take your medication! Many websites can offer further tips, advice and support, such as www.scriptyourfuture.org. Stick with your medication Phosphate binders won’t make you feel better right after you take them. You might feel that you can skip a few tablets, or a week of tablets, and it won’t make much difference. But, over time, high levels of phosphorus can lead to heart attacks, strokes or a stay in hospital with bone fractures. So make a pledge to yourself that you will stick with your medication! If it´s not working out, ask for help There are always other options that you can try (maybe a different tablet, a different dose or a new schedule) so, in order to stay as healthy as possible, always ask for help and don’t just stop taking your medication. Find references online: www.compact-renal.com/service-center/patient-material/
  • 3. CMOPACT Renal Patient material Comprehensive treatment of hyperphosphatemia Why is it important to control your phosphate levels? If your kidneys aren’t functioning properly, phosphorus can build up in your blood, leading to hyperphosphatemia (high phosphorus levels). High phosphorus levels might not cause any symptoms today... …but they store up problems for tomorrow Bone disease & fractures Heart disease High phosphate pulls calcium from your bones. Dialysis, diet & medication all help to control phosphorus levels Dialysis alone cannot control phosphorus levels, which is why doctors also recommend that you follow a well-planned diet and can prescribe you phosphate binder tablets as well. A low phosphorus diet helps to reduce your phosphate levels. Phosphate binder tablets act in stomach and gut binding phosphorus before it is taken into blood circulation. The extra calcium from your bones can end up in your arteries & heart. This can make your bones weak and more likely to break. This can lead to heart complications, such as heart attack or stroke. P P P P P Ca Ca Ca P P Find references online: www.compact-renal.com/service-center/patient-material/
  • 4. COMPACT Renal Comprehensive treatment of hyperphosphatemia references Healthy tips for low phosphorus Check the nutrition label > phosphorus low/medium/high ratio: Your guide to the new food label: http://www.kidney.org/atoz/content/foodlabel Check the ingredients > link between calcium fortification & high P: Cerklewski, Florian L. “Calcium fortification of food can add unneeded dietary phosphorus.” Journal of Food Composition and Analysis 18.6 (2005): 595-598. Swap food & drink choices Multiple sources, including: > Phosphorus in Foods: What to Know When You‘re on a Kidney Diet: http://www.davita.com/kidney-disease/diet-and-nutrition/ diet-basics/phosphorus-in-foods:-what-to-know-when-you%27re-on-a-kidney-diet/e/10253 > NKF/Fresenius patient materials > USDA nutrient database > Low-phosphorus diet: Best for kidney disease? http://www.mayoclinic.org/food-and-nutrition/expert-answers/faq-20058408 > Phosphorus and your CKD diet: http://www.kidney.org/atoz/content/phosphorus Tips to help with binders FDA Consumer Update: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm164616.htm CDC Medication Adherence advice (to providers): http://www.cdc.gov/primarycare/materials/medication/docs/medication-adherence-01ccd.pdf NICE Guidance (to providers) for improving adherence: http://www.nice.org.uk/guidance/cg76/chapter/1-guidance Why is it important to control P? P build-up in bloodstream Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998; 32:S112. Pulling calcium from bones Goltzman, David. “5 Parathyroid Hormone: Its Role in Calcium and Phosphate Homeostasis.” The Physiological Basis of Metabolic Bone Disease (2014): 103. Heart complications Hruska, Keith A., et al. “Hyperphosphatemia of chronic kidney disease.” Kidney International 74.2 (2008): 148-157. Shanahan, Catherine M., et al. “Arterial calcification in chronic kidney disease: key roles for calcium and phosphate.” Circulation research 109.6 (2011): 697-711. Treatment options Fouque D, Horne R, Cozzolino M, Kalantar-Zadeh K. Balancing nutrition and serum phosphorus in maintenance dialysis. Am. J. Kidney Dis. 2014;64(1):143-150. doi:10.1053/j.ajkd.2014.01.429.