Phosphorus is a vital nutrient, but disturbances in phosphorus homeostasis are central to chronic kidney disease-mineral and bone disorder. To minimize disturbances, traditional dietary guidance focused on a numerical phosphorus target leading to the exclusion of many healthy foods and implementation challenges. Contemporary phosphorus guidance focuses on dietary source, avoiding additives, and emphasizing low-phosphorus bioaccessibility foods, leading to a more liberal approach. Additional work is needed to demonstrate the efficacy of these contemporary approaches and understand the influence of specific foods, processing, and cooking methods. Unfortunately, patient education using traditional and contemporary strategies may give mixed messages, particularly related to plant-based foods. Thus, greater clarity on the effects of specific foods and dietary patterns may improve phosphorus education. This review aims to discuss the evolution of dietary phosphorus management while highlighting areas for future research that can help move the field toward stronger evidence-based guidance to prevent and treat hyperphosphatemia.


This is the author-accepted manuscript of Annabel Biruete, Kathleen M. Hill Gallant, Lyn Lloyd, Anthony Meade, Sharon M. Moe, David E. St-Jules, Brandon M. Kistler. ‘Phos’tering a Clear Message: The Evolution of Dietary Phosphorus Management in Chronic Kidney Disease, Journal of Renal Nutrition, Volume 33, Issue 6, Supplement, 2023, Pages S13-S20, Copyright Elsevier, it's made available here CC-BY-NC-ND, and the version of record is available at DOI: 10.1053/j.jrn.2023.05.004.


phosphorus, Diet, chronic kidney disease, hyperphosphatemia, mineral and bone disorder, dietary intake

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Available for download on Friday, November 01, 2024