Implication of Phosphorous in a Kidney Disease

The kidneys are designed not only to filter out the waste products from the body, but also reabsorb important minerals and electrolytes from the filtrate before it reaches the urinary bladder in the form of urine. This very essential function known as selective reabsorption is responsible for maintaining the acid-alkali balance of the body.

This acid-alkali balance is basically the pH of the blood, which is maintained at 7.2-7.4. Under normal conditions, the kidneys are able to do its job without any problems.

What Do The Kidneys Eliminate?

The kidneys eliminate metabolic waste products like uric acid, creatinine, urea, nitrogenous wastes and excess of certain minerals like phosphorus. However when one has kidney disease, this function is hampered. In chronic kidney disease the filtration function of the kidneys is drastically hindered and this can lead to a serious, life threatening build up of toxins and excess minerals like phosphorous in the body.

Role of Phosphorous in the Body

Phosphorous is an important mineral found in bones and teeth. It is absorbed by the small intestines and stored in the bones. The role of phosphorous is varied and it is used for maintaining strong bones and teeth, production of energy, metabolism of proteins, fats and carbohydrate. It is also required for the muscle upkeep, production of hormones.

Phosphorous and calcium levels are kept in balance by the kidneys. The active form of vitamin D is called calcitriol, this helps in increasing the absorption of calcium from the diet. Kidneys do this important conversion of vitamin D into its active isomer.

Phosphorous Levels in Kidney Disease

In kidney disease, calcitriol levels are low and so the subsequent levels of calcium are also low. This causes absorption of calcium from the bones by the production of a hormone called parathyroid hormone. Phosphorous levels are also high due to improper excretion. The calcium, which is now available free in blood from the bones coupled with excess phosphorous combine to create a plethora of serious health issues.

Excess levels of phosphorous in the body are very harmful and can cause heart problems, bone disease and bone pain, itching, calcification of important organs like heart, joints, skin or lungs due to hard deposits of phosphorous and calcium. These symptoms of excess phosphorous are seen in stage 4 or 5 of end stage kidney disease.

How Excess Phosphorous is Managed?

The main treatment modality for lowering phosphorous levels in the blood is to refrain from eating food items that are high in phosphorous. All other treatment pathways are an adjunct to this.

Avoid these Foods

The patient will be advised to refrain from eating milk and milk products, fats, beer, chocolate drinks, bran, brown rice/ wild rice, organ meats and avocado. Use instead non dairy creamers, herbal teas, gluten free white bread, white rice, fresh or frozen meats, fruits and vegetables, water, and honey.

Use of Phosphorous Binders:

After eliminating sources of phosphorous from food, the next goal of therapy is to include drugs that will help keep phosphorous in the stomach and inhibit its absorption. These are chelating drugs that will effectively remove extra phosphorous from the body. These work in the stomach and small intestines where the food is broken down. So always take them with your meal.

Active form of Vitamin D

Calcitirol, the active form of Vitamin D is given to balance the levels between calcium and phosphorous. But this medicine is not given if the levels of calcium and phosphorus are too high because the excess phosphorous might get deposited in lungs, eyes or tissues.

Dialysis

It is reserved for patients in whom the phosphorous levels are too high and not managed by other means. Make sure to stick to the entire course of dialysis in order to gain maximum benefit from the treatment.

Managing excess phosphorous requires thorough knowledge of the food products to be taken and the ones to be avoided. Work closely with your doctors and nutritionist to manage the intake. Regular exercising will also help in improving bone strength. Since this is due to the underlying kidney dysfunction, once this is treated, the imbalance will automatically regulate itself.

The best treatment however, is natural medicines/treatment. There is much one can do to help reverse the kidney damage, and restore kidney function. By doing this you truly are treating the cause, and therefore rather than putting out spot fires with drugs and other treatments, you will be able to encourage your body to do the job for you like it was designed to do.

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