How Can Phosphorus Affect CKD Patients?

With regards to Renal and Urology News, Csaba P. Kovesdy, MD describes chronic kidney disease (CKD) as a slow, progressive loss of renal function and since about 90% of plasma phosphates are filtered in the glomerulus and 80%-97% of the filtered load is reabsorbed (mostly in the proximal tubule), gave the doc reason to believe that phosphorus may be a possible culprit. As mentioned in the article, the main regulators of proximal tubular reabsorption are the plasma phosphorus level and various hormones with phosphaturic properties, the main ones being parathyroid hormone (PTH) ² and fibroblast growth factor 23 (FGF-23).
Frank hyperphosphatemia is a relatively rare occurrence in CKD, but higher levels of plasma phosphorus (even within the range regarded as “normal”) is associated with higher mortality and worsened progression of CKD. Lowering plasma phosphorus levels in CKD can be beneficial in treating SHPT, and could become an additional therapy to lower mortality and to alleviate progressive loss of kidney function.

http://www.renalandurologynews.com/how-phosphorus-affects-ckd-patients/article/58147/#

Are those with high levels of Phosphorus at risk? "Stay tuned for more Research..."

According to David Douglas of Reuters Health, Dr. Ramachandran S. Vasan with the Framingham Heart Study, Massachusetts, and colleagues point out in their report in the Archives of Internal Medicine that higher levels of phosphorus are associated with increased heart-related deaths in patients with chronic kidney disease or prior heart disease.
During an average follow-up of more than 16 years, there were 524 cardiovascular disease events. After accounting for other heart risk factors and kidney function, a higher blood level of phosphorus was associated with an increased risk.
Compared to those with the lowest levels of phosphorus, those with the highest had a 55 percent greater risk of heart disease. While more research is necessary, Douglas mentions that "Dr. Robert N. Foley of the Minneapolis Medical Research Foundation, Minnesota notes that if the connection is indeed confirmed, potential treatments for lowering phosphorus levels already exist".

http://www.reuters.com/article/idUSCOL57142320070525

Soda and Osteoporosis: Could Phosphoric Acid be to Blame?

Phosphoric acid, an important bone mineral, happens to be a main component in sodas and leading many researchers to believe that it may be linked to osteoporosis. However, it is of equal importance to note (and is also mentioned in this article) that if someone is drinking a lot of soda, then they are most likely not drinking a lot of milk or nutritious beverages thereby having a decreased calcium intake.

It was also noted that caffeine can collaborate with this lower bone mineral density (BMD) trend since they found that women who drank dark cola-based beverages had a 4% lower BMD in the hip, even when researchers controlled for calcium and vitamin D intake.

Some of the steps the article recommended to take in order to boost bone health are to:

• Cut out one or two cans a day (depending on how much you drink). The Tufts study indicates that it might help to switch to a non-cola soda (like Sprite or Mountain Dew).
• Better still, for every soda you skip, reach for a glass of milk or fortified orange juice instead. Not only will you be cutting back on any harmful effect from the soda itself, you'll be adding calcium. (If you're a diet soda drinker worried about calories, here's a plus: fat-free milk has even more calcium than higher-calorie whole milk.)
• Have a breakfast cereal fortified with calcium -- and pour milk on top.
• Add milk instead of water when you prepare things like pancakes, waffles, and cocoa.
• Add nonfat powdered dry milk to all kinds of recipes -- puddings, cookies, breads, soups, gravy, and casseroles. One tablespoon adds 52 mg of calcium. You can add three tablespoons per cup of milk in puddings, cocoa and custard; four tablespoons per cup of hot cereal (before cooking); and 2 tablespoons per cup of flour in cakes, cookies and breads.
• Take a calcium and vitamin D supplement if you aren't getting enough calcium (1000-1300 mg, depending on your age) in your diet.
• Get plenty of weight-bearing and resistance exercise. 

http://www.webmd.com/osteoporosis/features/soda-osteoporosis?page=2

RDA and Food Sources of Dietary Phosphorus

Recommended Daily Allowance (RDA's) for dietary phosphorus are listed below. It is safe to say that most people do not need to take phosphorus supplements because optimal levels of dietary phosphorus can be attained from dietary sources mentioned below.

Pediatric

• Infants 0 - 6 months: 100 mg daily
• Infants 7 - 12 months: 275 mg
• Children 1 - 3 years: 460 mg
• Children 4 - 8 years: 500 mg
• Children 9 - 18 years: 1,250 mg

Adult

• Adults 19 years and older: 700 mg
• Pregnant and breastfeeding females under 18 years: 1,250 mg
• Pregnant and breastfeeding females 19 years and older: 700 mg

Dietary Sources Include:

• Dairy products
• Meat
• Poultry
• Fish
• Whole grains including flour and cereals
• Nuts
• Seeds
• Eggs
• Dried beans
• Peas
• Legumes 
• Hard potatoes
• Dried fruit
• Garlic cloves

http://www.umm.edu/altmed/articles/phosphorus-000319.htm

http://www.mmeade.com/cheat/phosphorus.html

What Can Phosphorus Do for You?

Along with B vitamins, phosphorus is needed to extract energy from food, especially fats and starches. Aside from helping kidney function and heart regularity, some other benefits of phosphorus may include:

• Speeding up the healing process and putting a stop to calcium loss from injury.
• Helping to prevent and treat osteoporosis.
• Helping treat or forestall bone diseases like rickets.
• Preventing stunted growth in children.
• Helping break up and carry away fats and fatty acids in your blood, as well as keeping your blood balanced.
• Working to keep your nerves from feeling frazzled, and your mind alert and sharp.
• Helping stimulate your glands to secrete hormones.
• Letting you digest two members of the B-vitamin family, riboflavin and niacin.
• Assuring transmission of impulses from one nerve to another.
• Giving you stable and plentiful energy.
• Forming the proteins that help all of us reproduce.
• May help block cancer.

http://www.mmeade.com/cheat/phosphorus.html

An Abundant Mineral in the Body

Next to calcium, phosphorus is the most abundant mineral in the body. While about 85% of phosphorus can be found in the bones and teeth of our bodies, it also works hand in hand with calcium to build strong bones and teeth. Present in cells and tissues throughout the body, phosphorus helps filter out waste in the kidneys and plays an essential role in how the body stores and uses energy. Not only does phosphorus help reduce muscle pain after a hard workout, it is also needed for the growth, maintenance, and repair of all tissues and cells, most notably for the production of our genetic building blocks, DNA and RNA. Phosphorus also helps balance and use other vitamins and minerals, including vitamin D, iodine, magnesium, and zinc.