Hi all, I hope all is well with you guys. First, before I get into the topic at hand, I need to continue on my mission to spread the word about the continued awareness of Chronic Kidney Disease (CKD), which is very seriously on the rise in this country and all over the world for that matter. People listen! take notice! get a clue! The awareness of CKD, truly needs to grow, and people should very seriously consider being tested for possible early stage CKD, especially those with a history or family history of diabetes and/or high blood pressure (two of the main causes of CKD), and if diagnosed with early stage CKD is the diagnosed, the good thing is that preventive measures can be taken to help in prolonging or even in some cases, can reverse the progression of CKD, isn't that awesome news. We at the San Francisco Chapter of the PKD Foundation, vigorously continue to spread the awareness of CKD, and urge people to get tested for early stage CKD, and we also encourage organ donation as well. I have been watching the weather channel, checking the tracking of ISAAC, I was born in New Orleans, and raised in Houma, and I am concerned about my family back home, and hope that they will get through this years hurricane season with minimum drama, because they have suffered and been through enough with the devastation of Katrina, about seven years ago. Though this storm has made its presence, life goes on, and on with the pressing topic for today - High phosphorus issues, in which many renal/dialysis pts. have issues with. Let me share with you my saga of coping with high phosphorus issues with my renal diet. When I first diagnosed with ESRD in 1990, I didn't have issues during the beginning days of hemodialysis, however, within a month I began to experience symptoms of having elevated phosphorus levels in my body. First, I notice I was beginning to scratch, like a crazy fool, like I had lost my mind, it truly got the best of me, and I didn't for the life of me, knew why I was experiencing this, and keep in mind, I was trying to adjust to hemo and also learning to manage that renal diet (in which I soon discovered that was quite a complex diet to follow). I became concern, when I thought I was doing everything that was necessary to help keep my phosphorus levels in normal range, as best as I could. I mean, taking my binders as prescribed, wasn't doing its job, because my monthly report would come back with a phosphorus of the high 5.0 to 6.0. I spoke to my dietitian about my phosphorus, and she ask me to keep a record of what I ate for a week, and then she could determine if I need to modify my renal diet, where the phosphorus is concerned. Finally, a week passed, and I gave her the record of my weekly menu, and then she noticed, that I was eating too much cheese, I didn't have any issues with cola or chocolate, because I completely gave both of those favorites up in the beginning of hemo. She then gives me a chart that listed a low, moderate to high phosphorus foods, and then she ask me how many binders, am I taking, and I told her five binders, I take three before my meals and two during my meals, and then she ask me, how long does it take me to eat. Well I was aware I am a very slow eater, and she came to the conclusion that the way I was taking my binders, just wasn't working for me, so she told me to start taking my binders, three before my meals and two at the end of my meals, well this began to work so much better for me. The sole purpose of the binders, is to help bind the food before it could reach the bloodstream. I began to look at the list on a regular basis religiously, especially when preparing a homemade recipe or a renal friendly recipe that I have collected, and have been collecting at present for well over two decades. Referring to this list, has helped me tremendously in the last fifteen years, to learn about what foods contain what amount of phosphorus, and even potassium for that matter. Now lets get back to some very important facts on why it is so important in keeping the phosphorus in normal range as much as possible. Attempting to maintain the phosphorus in normal range of 3.5-5.5, it is very important to be aware of how much phosphorus is in the contents of whatever food you are cooking for your meals, and of course, taking your binders as prescribed will help to limit the amount of phosphorus in the body, and the binders to do their part, in grabbing or bounding the phosphorus before it can reach the bloodstream. Now if you become naughty and stubborn about monitoring the amount of phosphorus foods that you consume, you can potentially start to have uncontrollable itching of the body, and further neglecting your renal diet, and continuing to eat high phosphorus foods and even not taking your binders as instructed, you could experience your bones becoming brittle, hardening of the blood vessels and body organs, which leads to heart attack, and the potential of the development of bone disease and calcification in soft tissues (such as the heart & lungs), pain in the bones and joints, and of course red eyes. I would like to share something with you, about a decade ago, during the early training days of transitioning from hemo to PD, I saw a display on the wall of the PD department, that truly terrified me, people it was so hideous looking, if you saw what I was viewing, you wouldn't want your phosphorus to get that out of control ever, and having this continuing high levels of phosphorus in your body, you can develop calcification in your eyes, foot, etc.etc, it just looks so creepy, there was a display of a foot, that was almost totally black, from all this calcification. I literally became sick to my stomach. That is the main reason why I try to not eat chocolate or drink any cola like sodas in the last fifteen years. Having those itching attacks in the past, was not a joke, sometime I could practically lose my mind, scratching like a crazy person, and then damaging my skin at some point. I don't have much problems with high phosphorus foods, but I still have an ongoing challenge staying away from cheese, I simply adore cheese and dishes cooked with cheese, such as pasta dishes. Now, that were some particular foods, that my dietitian stressed that I should stay away from as much as possible, such as Ice Cream, yes! I said Ice Cream, Cream Soups, Chowders, Peanut Butter, Whole Wheat Bread, (and they must have been speaking of non-diabetics, right!), Chocolate, yeah Chocolate! I know what you are thinking, damn! it seems like everything we have grew up to love is practically off limit for our renal diet (believe me I sympathize completely). Now when it comes to sodas, we truly as renal/dialysis pts, need to stay clean away from dark sodas, and my dietitian said that light sodas, such as 7-UP, Sprite, or Ginger Ale. I drink ginger ale on the regular, even when I have an upset stomach, but I drink it flat and at room temperature, (that is when it most effective). Just remember, fellow dialysis pts. Mr. Phosphorus is lurking around the corner, this mineral can be an enemy to dialysis pts. And even though it is not mandatory for products to into nutrtional facts about the phosphorus in its contents, it does specify in the ingredients and form of phosphorus. Here is some hidden sources of phosphorus to look out for: Phosphoric Acid, Pyophosphates, Hexametaphosphate, Dicalcium Phosphate, Monocalcium Phosphate and Sodium Phosphate. You know my dietitian even told me to stay away from Hawaiian Punch, yeah! thats right! And I began to think, I have always loved drinking Hawaiian Punch, besides I grew up on this stuff, My mom would make it from concentrate, my sisters and I would even take the leftover punch from the pitcher, and make the juice into frozen cups, talkin bout good! And I didn't type wrong, it is typed just like I said it (lol). I want to share with you a list of cheeses and exactly how much phosphorus they contain. check it out, it could potentially be very beneficial for your renal diet.
Phosphorus
Low - 150 mg
brie - 1 oz - 53 mg
feta - 1 oz - 96 mg
cottage cheese - (non-fat) - 1/2 cup - 76 mg
Cream cheese - 1 oz - 30 mg
Cream -half/half - 1 tbsp - 14 mg
Moderate - higher - 151 to 200 mg
cheese, blue - 1 oz - 110 mg
cheese, cheddar - 1 oz - 145 mg
cheese, mozzarello - 1 oz - 105 mg
cheese, provolone - 1 oz - 141 mg
cheese, swiss - 1 oz - 171 mg
cottage cheese - 4% fat - 1/2 cup - 139 mg
cottage cheese - 2% fat - 1/2 cup - 170 mg
Highest category - 201 mg or more
buttermilk - 1 cup - 219 mg
cheese, parmesan - 1 oz - 229 mg
cheese, ricotta, part skim - 1/2 cup - 226 mg
Milk, evaporated skim - 1/2 cup - 248 mg
Milk, nonfat - 1 cup - 247-275 mg (note: depending on the brand)
Milk, whole - 1 cup- 228 mg
Processed American cheese - 1 oz - 211 mg
I hope this helps those dialysis pts. out there, who have an issue with phosphorus, where cheese is concerned (like I do from time to time), especially when preparing and cooking recipes that contain cheese, you may have to limit the cheese used in the recipe, or substitute it for another lower phosphorus cheese. a tip to share: when I would make one of my renal friendly chef salads, I would opt to use the finely grated cheese, such as mozzarello, cheddar or swiss cheese, so that I wouldn't get too much phosphorus in my renal diet.
Well until my next blog, stay compliant with your renal diet, Look Out! for Mr. Phosphorus at all cost, because high phosphorus is not your friend, dialysis pts. (lol).
take care and all the best to all my followers.
Glo
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