- With Mayo Clinic urologist
Erik Castle, M.D.
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Erik Castle, M.D.
Erik Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancer.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is president of the international Society of Urologic Robotic Surgeons. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
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Question
Low-phosphorus diet: Best for kidney disease?
I have kidney disease, and my doctor told me to reduce the amount of phosphorus in my diet. Why is this important? And what foods contain phosphorus?
Answer
from Erik Castle, M.D.
The kidneys help regulate the level of phosphorus in your blood. If your kidney function is impaired, eventually you'll likely have elevated phosphorus levels (hyperphosphatemia). In turn, the elevated phosphorus decreases the level of calcium in your blood, which can lead to bone disease.
Nearly every food contains some phosphorus, so you can't eliminate all phosphorus from your diet. However, it's helpful to limit or avoid phosphorus-rich foods, including:
- Milk and milk products
- Whole grains, including bread, crackers, cereal, rice and pasta
- Dried beans, peas and lentils
- Organ meats, including liver, tongue, kidney, heart and giblets
- Nuts and seeds, including peanut butter and other nut butters
- Chocolate and other candies made with milk, such as caramels
- Cola soft drinks
Also think about possible food substitutions.
| Instead of these higher phosphorus foods: | Choose these lower phosphorus foods: |
|---|---|
| Milk, pudding or yogurt | Rice milk (unfortified) or nondairy creamer |
| Cream soup made with milk | Broth-based soup made with water |
| Hard cheese | Cream cheese |
| Ice cream or frozen yogurt | Sherbet or frozen fruit pops |
| Whole-grain bread, crackers or cereal | Refined (white) bread, crackers or cereal |
| Quick breads, biscuits, cornbread, muffins, pancakes or waffles | Refined dinner rolls, bagels, English muffins or croissants |
| Dried peas, beans or lentils | Asparagus, green beans, wax beans, broccoli, beets, cabbage, carrots, cucumbers, peppers, lettuce, onions, tomatoes, spinach or summer squash |
| Organ meats | Beef, pork, lamb, poultry or fish |
| Peanuts | Popcorn |
| Chocolate | Hard candy or gumdrops |
| Cola soft drinks | Lemon-lime soda, ginger ale or root beer |
This chart is only a partial listing of suggestions for foods lower in phosphorus. Your needs may vary depending on your kidney function.
It's also important to remember that even if you choose foods lower in phosphorus, there are still limits. Often, 800 to 1,000 milligrams (mg) of phosphorus a day is the limit for someone who has kidney disease. To track your phosphorus intake, read nutrition labels carefully. Keep in mind that phosphorus is usually listed as a percent of Daily Value. To calculate how many milligrams of phosphorus are in one serving of a particular food, multiply the percent listed by 1,000.
If your doctor recommends limiting your dairy intake, ask if a calcium supplement would be appropriate. Also, be sure to avoid medications and supplements that contain phosphorus.
For help creating a meal plan that meets your individual needs — including any other dietary restrictions you may have, such as limits on sodium, potassium and protein — consult a registered dietitian. He or she can help you make sure that you're getting adequate nutrition while following the dietary guidelines provided by your doctor.
