Elevated serum
phosphorus has been identified as a cardiovascular risk factor in
chronic kidney disease (CKD) patients and a clear understanding of
phosphorus homeostasis is very important for practicing nephrologists. At any particular point, serum
phosphorus levels reflect the balance between movements of this
mineral from and into the intestine, bone, intracellular space, and kidneys. We briefly review here all these exchanges with a particular emphasis on
dietary phosphorus intake. Despite all the oral
phosphorus binders currently available in the market,
dietary restriction of this
mineral remains a cornerstone for the prevention and treatment of
hyperphosphatemia. An effective restriction of dietary intake of
phosphorus requires prescription of a moderate
protein intake (0.9-1.0 g/kg/day) and restricted consumption of highly processed fast and convenience foods.
Phosphorus added during food processing is an important source of this
mineral because of its magnitude and high bioavailabilty. Moreover, as food manufacturers are not required to label the amount of
phosphorus added during food processing, a significant amount of the current daily
phosphorus intake remains unaccounted when estimating
phosphorus intake in CKD patients. The recent development of low
phosphorus-containing food products represents a very useful addition for CKD patients.