Controlling your Phosphate Intake: Step 1

Transcription

1 University Teaching Trust Controlling your Phosphate Intake: Step Ladywell Building Dietetic Department All Rights Reserved 208. Document for issue as handout.

2 Name: Dietitian: What are Phosphate and Calcium? Phosphate and calcium are minerals that come from the food you eat and are needed to maintain strong healthy bones. Your kidneys help to control the levels of phosphate and calcium in your blood. Phosphate and calcium work together to keep your bones, teeth, heart and blood vessels healthy. These levels are difficult to control when the kidneys are no longer working properly. An imbalance can lead to weakening of the bones and a build up of calcium in blood vessels. If your levels of calcium and phosphate go too high in your blood then this can cause serious problems. Symptoms of a high blood phosphate level are: l Itchy skin and eyes l Bone pain and tenderness l Weak bones that may break more easily l Joint pain in the lower back, hips and thighs l Painful feet l Muscle weakness and problems walking l Cold, tingling hands and feet If high levels continue then calcification may result. This occurs when calcium and phosphate join together to form hard deposits. These deposits can form in the heart, lungs, blood vessels and joints. This can lead to many problems including heart disease and put your chances of having a transplant at risk. 2

3 How can I control the level of phosphate in my blood? To help you control your phosphate levels, you will need to reduce the amount of phosphate in your diet. Dairy foods are high in phosphate and need to be moderated. Follow the guidelines below: Milk Cheese Eggs Milky Puddings Daily / Weekly Allowance / 2 pint (300mls) of milk per day. This can be skimmed, semi-skimmed or full fat. / 3 pint (90mls) of milk can be swapped for a yoghurt or a portion of custard or milky pudding. 4oz (00g) hard cheese per week e.g. Cheddar, Edam, Lancashire, Red Leicester. Soft cheeses e.g. Brie, ricotta, feta are lower in phosphate. Alternatively choose cottage cheese (various flavours) or cream cheese. 4 eggs per week; boiled, fried, poached or scrambled. In addition you may also have a maximum of 4 items from the following list each week: l 25g pot of yoghurt l 25g custard (small bowl) l 25g milk pudding (small bowl) l 00g ice cream (2 scoops) In addition try to avoid the following high phosphate foods: Meats Fish Shellfish Cereals Drink Miscellaneous l Try to avoid using too many processed foods as phosphates are often used as preservatives and additives. You can often see the word phosphate or phos in the ingredients list e.g. phosphoric acid. This type of phosphate is very easily absorbed from your food, (see separate phosphate additives leaflet for more information) Veal, game, liver, kidney, heart, sweetbreads, pate. Tinned fish with bones, e.g. pilchards, sardines. Fish roe, kippers, whitebait, sea bass, monkfish, coley. Clams, Crab (fresh), scallops, scampi All bran, muesli and cereals containing nuts. Biscuits containing chocolate and nuts. Cakes and biscuits containing baking powder e.g. scones, crumpets. Puri with added baking powder. Savoury Indian snacks (e.g. chevda, gathia, sev). Malted milk drinks, drinking chocolate, cocoa, cola drinks. Nuts, chocolate, fudge, any Indian sweets containing milk powder or ground nuts. Other nuts (e.g. almonds, peanuts), twiglets, yeast, extract (e.g. marmite, Bovril), peanut butter, naan bread, pizza. l Where possible, use fresh foods to avoid the preservatives and additives 3 4

4 Phosphate binders In addition to limiting the amount of phosphate in your diet, you may also be prescribed some tablets known as phosphate binders. These tablets act like a sponge and bind with the phosphate in your food to stop it being absorbed into your body. Phosphate binders must be taken with all meals containing phosphate as prescribed by your doctor. The most commonly prescribed phosphate binders are shown below: l Phosex (calcium acetate) l Renacet (calcium acetate) l OsvaRen (calcium acetate and magnesium carbonate) l Sevelamer hydrochloride l Sevelamer carbonate l Fosrenol (lanthanum carbonate) l Velphoro (sucroferric oxyhydroxide) How to take your Phosphate binder Should be taken with food: l Phosex l Renacet l OsvaRen l Sevelamer Hydrochloride/ Sevelamer Carbonate l Velphoro (sucroferric oxyhydroxide) and Should be taken after food: l Fosrenol Further information about controlling your phosphate level is available from your dietitian. Renal Dietitians renaldietitians@srft. nhs.uk Notes 5 6

5 G W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 208 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: CS 5 (8) Review Date: June 2020 University Teaching Trust For further information on this leaflet, it s references and sources used, please contact Copies of this leaflet are available in other formats (for example, large print or easyread) upon request. Alternative formats may also be available via www. srft.nhs.uk/for-patients/patient-leaflets/ If you need this information leaflet translated, please telephone: In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities to access this service. Please contact the service/clinic you are attending by phone or prior to your appointment to discuss your requirements. Interpreters are available for both verbal and non-verbal (e.g. British Sign Language) languages, on request. Please contact the service/clinic you are visiting to request this. or InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on This is a teaching hospital which plays an important role in the training of future doctors. The part patients play in this process is essential to make sure that we produce the right quality doctors for all of our futures. If at any time you would prefer not to have students present please inform the doctor or nurses and this will not affect your care in anyway. Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients