Phosphorus occurs natually in many foods, including whole grains and dairy products, and is important for the building of strong bones and teeth. However for those individuals on dialysis or in renal failure, close monitoring of phosphorus levels---and phosphorus intake---is crucial to good health.

Phosphorus additives are present in many fast foods and are generally added for reasons of leavening, flavor enhancement, or as preservatives. Since phosphorous additives are largely absorbed by the body, this additional phosphorous in the system can be dangerous, and there are many tools available to assist renal patients in understanding and controlling their phosphorus intake. 

As was stated above, phosphorus does indeed assist in promoting and maintaining the health of bones and teeth. Phosphorus also plays a part in metabolism, helping to convert food into useable energy. Whereas healthy kidneys can efficiently excrete excess phosphorus into the urine as waste, diseased or compromised kidneys cannot, and thus phosphorus levels must be monitored closely to prevent damage to both the bones and the heart.  

Even though individuals on dialysis will often take medications known as phosphorus binders in order to remove excess phosphorus from the blood stream, the medications combined with the action of dialysis itself will not necessarily remove enough of the chemical from the system if the patient's phosphorus intake is high. 

In the interest of the health of individuals on dialysis---many of whom are likely to be of lower socioeconomic status and prone to turn to fast food for convenience and affordability---the Case Center for Reducing Health Disparities has compiled lists of the phosphorus content of many popular fast foods, offering alternative choices for the concerned renal patient. The Case Center's website offers free downloads of pdf files reviewing the phosphorous content of foods from Arby's, Boston Market, Bruegers Bagels, Burger King, Dairy Queen, Domino's, Dunkin' Donuts, KFC, McDonald's, Panera Bread, Papa John's, Pizza Hut, Subway, Taco Bell, and Wendy's. These invaluable files can be downloaded, printed, and distributed to patients interested in controlling their phosphorous intake and maintaining renal health. 

Other foods which often contain high phosphorus levels include deli meats and colas, and phosphorus can appear on ingredient lablels in many guises:

• Phosphoric acid
• Dicalcium phosphate
• Monocalcium phosphate
• Pyrophosphates
• Hexametaphosphate
• Polyphosphates
• Sodium phosphate

In the interest of our patients' health, it is important that such information be disseminated to those most at risk. And for those of us who work with lower income populations who are more apt to rely on fast food and processed foods for understandable economic reasons, it is our responsibility to make sure our patients are aware how such foods, however affordable (with their high fat content, high caloric content, and low nutritional value), often come at a greater price: good health. 

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NurseKeith is a nurse, writer, consultant and blogger. Please feel free to visit his blog, Digital Doorway .  

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Dialysis and fast food
written by SunnyRN, August 27, 2008

I had never thought of fast foods in terms of this before. I will talk to my friends who work in dialysis.

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