How to Lower Phosphate Levels Effectively

October 19, 2025 •

4 min read

According to the National Kidney Foundation, hyperphosphatemia affects many people with chronic kidney disease (CKD), and managing it is crucial for overall health. Learning what can lower phosphate levels is essential for those with impaired kidney function to prevent serious complications affecting the bones and heart.

Quick Summary

This resource provides comprehensive information on diet, medications, and lifestyle changes to manage high blood phosphate levels, particularly for individuals with chronic kidney disease.

Key Points

Avoid Phosphate Additives: Minimize or eliminate processed foods and drinks containing additives with "phos" in the ingredient list, as these are highly absorbed by the body.
Limit High-Phosphate Foods: Reduce consumption of naturally high-phosphate foods like dairy, nuts, and certain meats, while focusing on lower-phosphate alternatives.
Take Phosphate Binders as Prescribed: Use prescribed medication with meals and snacks to bind to phosphate in food, preventing its absorption.
Consider Cooking Methods: Boil vegetables and other foods in water and discard the liquid to help reduce mineral content.
Manage Dialysis Adherence: For those on dialysis, attending all scheduled sessions is important for removing excess phosphate from the blood.
Promote Bowel Health: Maintain regular bowel movements, as recommended by a healthcare provider, to assist with phosphate excretion.

Understanding Phosphate and Hyperphosphatemia

Phosphate is a vital mineral that works with calcium to build strong bones and teeth and produce energy within our cells. Healthy kidneys are responsible for filtering out excess phosphate from the blood. However, when kidney function declines due to conditions like Chronic Kidney Disease (CKD), the body can no longer effectively remove this mineral, leading to high phosphate levels, a condition known as hyperphosphatemia.

Chronic hyperphosphatemia can pull calcium from the bones, making them weak and brittle. Over time, it can lead to dangerous calcium-phosphate deposits in blood vessels and soft tissues, increasing the risk of heart disease and stroke. Therefore, managing phosphate levels is a critical component of care for people with kidney disease.

Dietary Modifications for Lowering Phosphate

Dietary changes are one of the most fundamental and effective ways to manage phosphate levels. The goal is to reduce your overall phosphorus intake, focusing on consuming foods with naturally lower levels or preparing them to reduce their phosphorus content.

Avoid Processed Foods with Phosphate Additives

One of the most significant strategies is to minimize or eliminate processed foods and drinks, which contain high levels of inorganic phosphate additives. These additives are almost completely absorbed by the body, unlike naturally occurring phosphate, which is only partially absorbed.

Common foods to avoid include:

Dark-colored colas and some flavored beverages: These often contain phosphoric acid.
Processed meats and poultry: Hot dogs, sausages, bacon, and pre-seasoned or enhanced meats frequently contain phosphate preservatives.
Processed cheeses and cheese spreads: Items like American cheese, processed cheese slices, and spreads have added phosphate.
Instant mixes and ready-to-eat foods: This includes instant puddings, frozen meals, and pancake or cake mixes.

Focus on Plant-Based Protein

Research indicates that phosphorus from plant-based foods is less readily absorbed than from animal sources. Incorporating more plant-based protein can help manage levels. However, it is essential to discuss portion sizes with a dietitian.

Low-phosphate protein sources include:

Lean, fresh meats, poultry, and fish (unprocessed)
Egg whites (the yolk is higher in phosphate)
Chickpeas, lentils, and fresh beans (in moderation)
Tofu and dried soya mince

Optimize Your Cooking Methods

Boiling can help reduce the phosphate content of certain foods, especially vegetables and some meats. This process causes minerals to leach out into the water, which should be discarded afterward. For vegetables like potatoes, boiling and discarding the water is a recommended practice to lower both phosphate and potassium levels.

Medications: Phosphate Binders

For many with advanced kidney disease, dietary changes alone are insufficient to control phosphate levels. In these cases, a doctor may prescribe a phosphate binder, a medication taken with meals and snacks that binds to the phosphate in food, preventing its absorption. The phosphate is then passed out of the body through stool.

Types of phosphate binders include:

Calcium-based binders: Calcium acetate (PhosLo®) and calcium carbonate (Tums®). There is a risk of hypercalcemia and vascular calcification with these binders.
Non-calcium, non-aluminum binders: Sevelamer (Renagel®/Renvela®) and Lanthanum carbonate (Fosrenol®). These are often preferred due to the risk associated with calcium-based binders.
Iron-based binders: Sucroferric oxyhydroxide (Velphoro®) and ferric citrate (Auryxia®). These can offer the additional benefit of supplementing iron levels.

It is critical to take phosphate binders exactly as prescribed by your healthcare provider, usually with the first bite of food, to maximize their effectiveness.

The Role of Dialysis

For patients with kidney failure, dialysis is a primary method for removing excess fluid and waste products, including some phosphate, from the blood. While dialysis is essential, it may not be enough to normalize phosphate levels on its own, especially with less frequent sessions. In such cases, strict dietary control and the use of phosphate binders remain crucial.

Other Strategies and Monitoring

Promoting bowel regularity is also important, particularly when taking phosphate binders, as constipation can affect phosphate control. A high-fiber diet, consisting of kidney-friendly fruits and vegetables, can help. Regular blood tests are necessary to monitor serum phosphate and calcium levels to ensure treatment effectiveness and guide any adjustments to your care plan.

Low-Phosphate Food Choices Comparison

To help in your dietary planning, this table compares high-phosphate foods to their lower-phosphate alternatives.


Food Category	High-Phosphate Foods (Limit/Avoid)	Low-Phosphate Alternatives (Enjoy)
Dairy	Hard cheeses, processed cheese spreads, ice cream, evaporated/condensed milk	Cream cheese, cottage cheese, ricotta, sorbet, cream, organic rice milk
Protein	Processed meats (hot dogs, sausages), organ meats (liver), sardines, offal, ham	Fresh, unprocessed meat (beef, chicken, pork), tuna (canned in water), egg whites
Beverages	Dark colas (Coca-Cola, Dr. Pepper), iced tea (bottled), beer, cocoa drinks	Water, herbal tea, lemonade, light-colored fizzy drinks, homemade iced tea
Carbs/Grains	Bran cereals, whole wheat bread, muesli, oatmeal	White rice, white bread, corn flakes, puffed rice, plain pasta
Snacks	Nuts, seeds, chocolate, bombay mix, potato crisps	Unsalted popcorn, pretzels, rice cakes, plain crackers

Conclusion

Effectively managing and lowering phosphate levels involves a multi-pronged approach that includes significant dietary modifications, potentially supplemented by prescribed phosphate binders. Avoiding processed foods with phosphate additives and opting for fresh, home-cooked alternatives is a crucial first step. Furthermore, controlling protein intake, choosing appropriate cooking methods, and attending all scheduled dialysis sessions (if applicable) are all essential. For those with kidney disease, working closely with a healthcare team, including a dietitian, is vital to creating a personalized plan and monitoring progress to protect long-term bone and cardiovascular health. For detailed information on kidney-friendly diets, visit the National Kidney Foundation website for authoritative resources.(https://www.kidney.org/kidney-topics/phosphorus-and-your-ckd-diet)

Frequently Asked Questions

Hyperphosphatemia is a condition characterized by high phosphate levels in the blood, most commonly occurring in individuals with impaired kidney function. It is a concern because excess phosphate can pull calcium from bones, weakening them, and contribute to mineral deposits in blood vessels, increasing the risk of heart disease and stroke.

Phosphate binders are medications that are taken with meals and snacks. They work by attaching to the phosphate in the food as it passes through the stomach and intestine, which prevents the body from absorbing it. The bound phosphate is then eliminated from the body in stool.

One of the most impactful changes is to avoid or significantly reduce processed foods and drinks, especially those with ingredients containing the word 'phos' (e.g., phosphoric acid). These inorganic additives are absorbed more readily than natural phosphate.

Not necessarily. While many dairy products and processed meats are high in phosphate, fresh, unprocessed meats, poultry, and certain dairy alternatives are lower. Similarly, choosing fresh, home-cooked options over processed ones is a good strategy.

A plant-based diet is often recommended as phosphorus from plant sources is less bioavailable and absorbed to a lesser extent than from animal sources. However, it is essential to discuss portion sizes with a dietitian, as some plant-based foods like nuts, seeds, and beans are still high in phosphate.

Boiling foods like vegetables and some meats can help reduce their phosphate content. By boiling them in plenty of water and discarding the water afterward, some of the minerals are leached out. This is particularly useful for foods like potatoes.

While dialysis effectively removes some waste products, including phosphate, the amount of phosphate absorbed daily from a typical diet can be significantly higher than what a standard dialysis session can remove. Less frequent sessions, such as three times a week, can make controlling phosphate through dialysis alone even more challenging.