If you are/have been a member of Club CKD or a caregiver of one, just like us at Team ATK, you probably know a thing or two about how the Renal Diet is an essential part of the treatment approach towards Chronic Kidney Disease, whatever be the cause. Among tweaking other nutrients, adjusting Phosphorus intake is an integral part of this CKD Diet.
WHAT IS PHOSPHORUS & WHY IS IT IMPORTANT?
HOW DO HEALTHY KIDNEYS HANDLE PHOSPHORUS IN THE BLOOD?
As mentioned in the first infographic, Phosphorus is a “structural mineral”. It is an integral part of the structure of our DNA, proteins and “boundary walls” of each cell. Phosphorus is also necessary for generating the “Energy molecule” — Adenosine Triphosphate (ATP) which is essential for sustaining life. However, when we talk about Phosphorus in terms of kidney disease, our chief concern is the Phosphorus present in the bloodstream. This part comes from absorbing Phosphorus from food in our intestines with the help of Activated Vitamin D from Kidneys.
In good health, blood levels of Phosphorus must range between 2.5-4.5 mg/dL. To ensure blood phosphorus levels remain within this normal range, the Recommended Dietary Allowance for Phosphorus is 800-1000 milligrams per day for a healthy individual.
Upon absorption from food, once Phosphorus in the bloodstream is adequately utilized for the respective body functions, kidneys filter-out the excess free Phosphorus from our blood. Now in any given day, various body functions need precise regulation of the blood-biochemistry often in a time frame of a billionth of a second. So our brilliant kidneys also remember to take care to “re-absorb” some of the filtered phosphorus back into the bloodstream as & when the need arises.
WHAT GOES WRONG WITH PHOSPHORUS METABOLISM WHEN KIDNEY DISEASE HITS
When Chronic Kidney Disease sets-in, the delicate specialized filtration zones within each of the million micro-filters (nephrons) in a kidney start getting scarred. As a result of this, renal handling of phosphorus takes a direct hit.
Initially, the blood levels of Phosphorus reduce in early stages due to its rampant urinary loss & lack of “re-absorption” back to our bloodstream. However, intriguingly, “free” phosphorus levels shoot-up once kidneys enter End-Stage Renal Disease (failure).
So why is that bad? Well, you see, Mother Nature taught our body organs to be content with what’s necessary & shun “greed”. So if blood phosphorus levels shoot-up beyond necessary levels, it won’t go and continue to strengthen our bones & teeth. Such “free” phosphorus desperately tends to deposit on other tissues and “eat-away” those tissues gradually.
To avert such catastrophic consequences, Parathyroid Hormone (PTH) released form Parathyroid glands nestled within our Thyroid Gland in the neck, volunteers to help.
PTH literally “coaxes” our bones to “donate” Calcium to the bloodstream to accompany the Free Phosphorus. As a result, Calcium leaches-out from bones to “bind” to some of this excess “free” phosphorus and prevents undesirable phosphorus deposition over other tissues. However, in the process, the bones turn really fragile and prone to fractures. The technical name for such kidney disease-mediated bone damage is “Metabolic Bone Disease” or “Bone Mineral Disorder”. It is an inevitable complication in every CKD journey.
So, the”altruism” by Parathyroid Hormone (PTH) & Bones to curb high blood levels of free phosphorus in CKD ultimately does something more concerning.
Bone Damage couldn’t be something you could compensate with, right? So, as a CKD sojourner, it is imperative that you learn ways to keep your blood phosphorus levels in check.
SO WHAT ARE THE WAYS TO CONTROL BLOOD PHOSPHORUS LEVELS IN CKD?
In CKD, one of the first things that your medical team would advise you on is diet modification. The technical name for this is “Medical Nutrition Therapy”. The more familiar term is the so-called “Renal Diet” or simply, CKD Diet. It is best to consult a registered Renal Dietitian (RD) as soon as you are diagnosed with Kidney Disease. Such professionals specialize in nutritional requirements for kidney patients. They will guide you on all permissible nutritional intakes for kidney disease. RDs will also provide you with a meal plan customized to your kidney function as evident in your blood-work.
However, incorporating such meal plans in your life is no mean feat. If you say adjust one ingredient, you end up consuming more than your allowance of another restricted nutrient. In a nutshell, it is easy to feel frustrated! And to think just how our Kidneys even handle all the blood components with absolute precision 24 X 7! Well, despair not. Managing your CKD Diet needs certain tips & tricks up your sleeve. A fragment of that is what today’s article aims to present before you.
To help you navigate through Phosphorus-control in your Renal Diet (CKD), presenting here, a series of PHOSPHORUS GUIDE GRAPHIC. Scroll along to learn what’s relevant & make a smooth transition to a Kidney-friendly lifestyle today.
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