How to control phosphate.

What is phosphate?

Phosphate is a chemical element which is found in many foods.

What does phosphate do?

Calcium and phosphate work together in the body to keep bones healthy and strong.

Why is too much phosphate in the blood a problem?

In renal failure the kidneys are unable to remove excess phosphate from the body. If phosphate levels rise too much calcium levels may fall, and Renal Bone Disease can occur as a result. This causes bones to become more brittle and even fracture.

What can be done to help?


A way of keeping phosphate levels normal is by taking tablets known as ‘phosphate binders’. Examples of these drugs include Calichew and Titralac.

These drugs bind to phosphate in the stomach and prevent blood phosphate levels from rising.


The foods that are high in phosphate are also high in protein. If you reduce your intake of phosphate containing foods, you will reduce your intake of protein. Adequate protein is essential to health and strength, so do not reduce your intake without discussion with the dietitian. It is especially important that you are taking the binders at the right time with the right foods.

Binders should always be taken with foods high in phosphate, otherwise they do not work. Ideally, they should be taken 10-15 minutes before a meal (unless specifically told otherwise)

Always take your full prescription of binders.

Try and adjust the binders through the day depending on the phosphate content of the meals.

The foods that are high in phosphate include:

  • Eggs.
  • Dairy produce e.g. milk, cheese and yoghurt
  • Fish which contain soft bones i.e. sardines, white bait.
  • Meat

For example:

Mrs Jones has been prescribed 3 Titralacs/day. On a typical day this is what Mrs Jones would eat.


2 slices of toast with spread and jam

cup of tea

glass of orange juice.

Mid Morning

2 digestive biscuits + a cup of tea.


egg or cheese on 2 slices of toast

a piece of fruit.

Evening Meal

Chops or roast meat + 3 x boiled potatoes, carrots, peas.


A cup of Horlicks made with milk.

Mrs Jones would get the best effect from the Titralac if she took one with lunch, one with her evening meal, and one with supper. This is because she takes a high phosphate food with all the above meals.

So…in summary

the best way to control your phosphate is to take your full prescription of binders daily.

The amount to be taken with each meal depends on the phosphate content of the meal.

If you are still unsure then ask to see the dietitian at clinic.

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