Dietary management of hyperphosphatemia in chronic kidney disease

Progressive deterioration of kidney function in chronic kidney disease (CKD) leads to retention of many substances, including phosphorus, that are normally excreted by the kidney. Serum phosphorous concentration, however, is usually maintained within the normal range by a variety of compensatory mechanisms until renal disease has progressed to approximately CKD-Stage 5. The challenge is to provide appropriate nutrition while maintaining phosphorus content within recommended limits. During dietary counseling of patients with CKD, the absolute dietary phosphorous content as well as the phosphorous-to-protein ratio in foods should be addressed. This study focuses on dietary management of hyperphosphatemia in CKD.