Article Figures & Data
Figures
- Figure 1.
Estimated daily P intake (in mg/d) from daily protein intake (in g/d) in 107 MHD patients from the NIED Study (30). Regression equation: P = 11.8*protein + 78 (r = 0.91, P < 0.001). Characteristics of the study population: 107 adult MHD patients from eight DaVita dialysis Clinics in Los Angeles area, 2001–2006. Dietary P intake 874 ± 1352 mg/d (range 294 to 2137 mg/d), dietary protein intake 66.6 ± 26.9 g/d (range 24.1 to 160.7 g/d), age 56.0 ± 12.4 years, men 60%, black patients 43%, Hispanic patients 36%, patients with diabetes 62%, dialysis vintage 42.1 ± 33.7 months, postdialysis dry weight 75.1 ± 20.8 kg (range 42.6 to 172.1 kg), single-pool Kt/V 1.58 ± 0.28. Dashed lines indicate predicated interval.
- Figure 2.
Association between the baseline dietary protein intake, represented by 13-week averaged nPNA (nPCR) and 13-week averaged serum P, in 30,075 DaVita MHD patients (P < 0.001 for trend). Adapted from reference (33), with permission.
- Figure 3.
Mortality predictability of 3-month averaged predialysis serum P concentration in 30,075 DaVita MHD patients. The y axis shows the logarithm of the risk ratio of all-cause mortality during 3 years of observation (July 2001 through June 2004). The multivariable regression spline models are adjusted for case mix and measures of nutritional status and inflammation. Dashed lines are 95% point-wise confidence levels. Adapted from reference (33), with permission.
- Figure 4.
Mortality predictability of the difference of the percentiles of the changes in dietary protein intake, represented by nPNA (nPCR), and serum P concentration in 30,075 MHD patients. The difference between nPNA and serum P concentration in each patient is a number between −0.98 and 0.98. The y axis shows the logarithm of the risk ratio of all-cause mortality during 3 years on the basis of a multivariable Cox regression spline model, adjusted for case mix and measures of nutritional status and inflammation. Dashed lines are 95% point-wise confidence levels. Each patient received a percentile score between 0.01 and 0.99 according to the percentile rank of the change in nPNA or serum P. Adapted from reference (33), with permission.
Tables
- Table 1.
Dietary P, protein, and potassium content of selected food items, ranked according to the P-to-protein ratio categories (64,65)
Parameter Serving Amount P (mg) Protein (g) K (g) P-to-Protein Ratio (mg/g) Commentsa P-to-protein ratio <5 mg egg whiteb 1 large 5 3.6 54 1.4 – pork rinds 1 oz 24 17.4 36 1.4 521 mg Na orange roughy fish 3 oz 87 19.2 154 4.5 – P-to-protein ratio 5 to <10 mg/g lamb 3 oz ∼170 ∼27.0 ∼203 6.3 c tuna, canned in water 3 oz 139 21.7 201 6.4 – chicken drumstick 1 drum 81 12.5 108 6.5 – beef (excludes organ meats) 3 oz ∼160 ∼23.0 ∼220 7.0 c ground beef 3 oz 165 21.9 258 7.5 – chicken breast 1/2 breast 199 26.7 220 7.5 – turkey (excludes organ meats) 3 oz ∼180 ∼24.0 ∼375 7.5 c yellow fin tuna 3 oz 208 25.5 484 8.2 – Nepro with Carb Steady (66) 8 oz 165 19.1 250 8.6 250 mg Na pork sausage 2 links 44 5.1 ∼124 8.6 – Novosource Renal (67) 8 oz 154 17.4 192 8.9 210 mg Na lobster 3 oz 157 17.4 299 9.0 – hotdog on bun, fast foodd 1 sandwich 97 10.4 143 9.3 670 mg Na pork (excludes organ meats) 3 oz ∼185 ∼20.0 76 9.3 c cod fish 3 oz 190 19.5 439 9.7 – taco, fast food 1 small 203 20.7 474 9.8 802 mg Na P-to-protein ratio 10 to <15 mg/g soy protein isolatee 1 oz 217 22.6 23 9.6 – egg substitutee 1/4 cup 76 7.5 207 10.1 – salmon, sockeye 3 oz 235 23.2 319 10.1 – crab, bluee 3 oz 175 17.2 275 10.2 – bagel (4″)e 1 89 8.7 132 10.2 – cheeseburger, fast foodd,f 1 sandwich 162 15.4 194 10.5 601 mg Na bolognaf 2 slices 92 8.6 179 10.7 417 mg Na cottage cheese, 1% milkfatf 1/2 cup 151 14.0 194 10.7 – halibut 3 oz 242 22.7 490 10.7 – tuna, canned in oil 3 oz 265 24.8 176 10.7 – tempeh 1/2 cup 171 15.8 305 10.8 – rainbow trout 3 oz 226 20.6 375 11.0 – tofu, rawe 1/2 cup 239 19.9 299 12.0 – beef jerky 1 large piece 81 6.6 118 12.3 438 mg Na peanut butter, chunkye 1 tbsp 51 3.9 119 13.1 – swordfish 3 oz 286 21.6 314 13.2 – whole egg 1 large 84 6.3 67 13.3 – frankfurter, beef and porkd 1 frank 72 5.1 75 14.1f 504 mg Na frankfurter, beef 1 frank 72 5.1 70 14.1 513 mg Na peanut butter, smoothe 1 tbsp 57 4.0 104 14.3 – lima beanse 1/2 cup 105 7.3 478 14.4 – soybeans, cookede 1/2 cup 211 14.3 443 14.7 – P-to-protein ratio 15 to <25 mg/g peanutse 1 oz 101 6.7 187 15.1 – baked beans with frankse 1/2 cup 135 8.7 305 15.5 557 mg Na edamame 1/2 cup 284 6.1 284 15.6 – black beanse 1/2 cup 120 7.6 306 15.8 – ricotta cheese, part skimf 1/2 cup 225 14.0 154 16.1 – kidney beanse 1/2 cup 125 7.7 357 16.2 – pinto beanse 1/2 cup 125 7.7 373 16.2 – chicken liver 1 liver 79 4.8 52 16.5 – cream cheesef 1 tbsp 15 0.9 20 16.7 – soymilke 4 fl oz 59 3.4 169 17.4 – Camembert cheesef 1 wedge 132 7.5 71 17.6 – bleu cheesef 1 oz 110 6.1 73 18.0 – lentilse 1/2 cup 178 8.9 366 20.0 – mozzarella cheesef 1 oz 149 7.4 27 20.1 – Munster cheesef 1 oz 133 6.6 38 20.2 – cheddar cheesef 1 oz 145 7.1 28 20.4 – Swiss cheesef 1 oz 161 7.6 22 21.2 – almondse 24 nuts 137 6.0 48 23.0 – walnutse 14 halves 98 4.3 18 25.0 – American cheesed,f 1 oz 145 6.3 200 22.8 – egg yolkb 1 large 65 2.6 125 22.8 – adzuki beans 1/2 cup 193 8.7 612 22.2 – feta cheese, Persian 1 oz 96 40.0 18 24.0 – P-to-protein ratio >25 mg/g biscuit, egg, sausage, sandwich, fast foodd,g 1 biscuit 562 20.0 268 28.1 – milk, low fat (2%) 1 fl cup 229 8.1 366 28.3 – pecanse 20 halves 79 2.6 116 30.4 – half and half 1 tbsp 14 0.44 20 31.8 – cashewse 1 oz 139 4.3 160 32.3 – tahini 2 tbsp 220 5.1 124 43.1 sunflower seeds 3 tbsp 370 6.2 272 59.7 – liquid nondairy creamerd 1 oz 19 0.3 0 63.3 -
For more information on the nutrient content of foods, search the USDA food composition database.
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↵a The quantitative sodium content is mentioned for high-sodium foods (>400 g of sodium per serving).
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↵b P-to-protein ratio of egg varies considerably: Whole egg 13.4; egg yolk 24.7; egg white 1.4 mg/g.
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↵c Values vary for cut of meat; average provided.
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↵d Product contains phosphate additives (see text).
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↵e P from nuts, seeds, and grains is ≤50% bioavailable than phosphorus from other sources (see text) (9).
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↵f See also Table 4 for the role of additive in the variation of P content of various cheese types.
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g High in sodium.
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Phosphate Salt Purpose Found in Dicalcium phosphate Calcium and phosphorus supplementation, dough conditioner Bakery mixes, yeast-raised bakery products, cereals, dry powder beverages, flour, food bars, infant food, milk-based beverages, multivitamin tablets, yogurt Disodium phosphate Sequestrant, emulsifier, buffering agent, absorbent, pH control agent, protein modifier, source of alkalinity, stabilizer Breakfast cereal, cheese, condensed milk, cream, evaporated milk, flavored milk powders, gelatin, half and half, ice cream, imitation cheese, infant food, instant cheesecake, instant pudding, isotonic drinks, nonfat dry milk, pasta, pet food, processed cheese, starch, vitamin capsules, whipped topping Monosodium phosphate Acidulant, buffering agent, emulsifier, leavening agent, protein modifier and sequestrant, gelling aid Cola beverages, dry powder beverages, egg yolks, gelatin, instant cheesecake, instant pudding, isotonic beverages, and process cheese custard pudding and no-bake cheesecake mixes Phosphoric acid Acidulant, pH control agent, buffering agent, flavor enhancer, flavoring agent, sequestrant, stabilizer, thickener, synergist Cola beverages, carbonated and noncarbonated beverages Sodium hexameta-phosphate Sequestrant, curing agent, dough strengthener, emulsifier, firming agent, flavor enhancer, flavoring agent, humectant, nutrient supplement, processing aid, stabilizer, thickener, surface-active agent, synergist, texturizer, buffering agent. Meat, seafood, poultry, vegetables, cream, half and half, ice cream, whey, processed cheese, eggs, table syrup, toppings Sodium tripolyphosphate Sequestrant, pH control agent, emulsifier, providing alkalinity, buffering agent, coagulant, dispersing agent, protein modifier, antioxidant, curing agent, flavor enhancer, humectant, thickener, stabilizer, texturizer Meat products, seafood, poultry, vegetable proteins, processed cheese, sour cream, dips, yogurt, eggs, table syrups, whipped toppings, pet food, vegetables, whey Tetrasodium pyrophosphate Buffering agent, pH control agent, alkalinity source, dispersing agent, protein modifier, coagulant, sequestrant, emulsification, color stabilizer Processed meat, poultry, seafood, processed cheese, potato products, ice cream, frozen desserts Trisodium phosphate Buffer, emulsifying agent, stabilizer, protein modifier, pH control, color stabilizer Processed cheese, cheese products, imitation cheese, isotonic beverages, cooked breakfast cereals -
Source: ICL Performance Products LP, St. Louis, MO 63141; http://www.perfperformancelp.com.
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- Table 3.
P content of selected beverages, mostly as a result of additives (based on 12-oz serving)
Brand Name Specification/Flavors P Content (mg) Contain <10 mg of P per 12-oz servinga 7 Up All flavors <10 Aquafina Essentials (excluding tangerine pineapple) <10 Barq's Root Beer All flavors <10 Dasani Water All flavors <10 Fanta Most flavors <10 Fresca All flavors <10 Vernors Ginger ale <10 Lipton Pure Leaf Teas All flavors <10 Mello Yellow All flavors <10 Minute Maid Fruit punch <10 Mountain Dew Most flavors (excluding Code Red) <10 Mug Root Beer All flavors <10 Nestea Tea Lemon Sweet <10 Pepsi Pepsi Natural <10 Root Beer (excluding Hire's) <10 Sierra Mist All flavors <10 Slice All flavors <10 SoBe Lifewater All flavors <10 Sprite All flavors <10 Tropicana Twister All flavors <10 Vault All flavors <10 Contain >10 mg of P per 12-oz serving AMP Energy All flavors 30 to 207 Aquafina Flavorsplash All flavors 93 to 128 Coca-Cola Classic All types 62 Diet Coke (Coca-Cola) All types 27 Dr. Pepper All types 68 Fanta Orange, red tangerine 11 Fruitworks All flavors 53 to 140 Gatorade and G2 All flavors 36 Hawaiian Punch All flavors 260 Lipton Brisk Tea Green, lemon, raspberry, sweet tea, no calorie lemon 98 to 189 Lipton Iced Tea (plastic bottled) All flavors 98 to 114 Lipton Sparkling All flavors 98 to 104 Mountain Dew Code Red 53 Mr. Pibb Pibb Xtra, Pibb Zero 44 Nestea Diet lemon, green tea citrus, diet green tea citrus, red tea pomegranate passion, raspberry 47 to 71 Pepsi Most colas (except Pepsi Natural) 54 Diet Pepsi All flavors 41 to 68 Propel Water All flavors 89 Tropicana Fruit Drinks All flavors 53 to 140 -
Source: Company websites and personal communication with manufacturers.
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↵a Most drinks have no P.
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Cheese US English Equivalent Terminology Fat in Dry Matter (%) P (mg) in 50-g Serving Cream and brie cheeses, 50-g serving Frischkäse Cream cheese 50 94 Briekäse Brie cheese 50 94 Soft cheese (Weichkäse), 50-g serving Butterkäse (Danish) butter cheese 60 178 Gorgonzola Gorgonzola (Italian blue cheese) 175 Camembert (45% Fett i. Tr.) Camembert (soft, creamy French cheese) 45 175 Camembert (60% Fett i. Tr.) See above 60 155 Mozzarella Mozzarella 150 Limburgerkäse (20% Fett i. Tr.) Limburger cheese with characteristic odor 20 143 Limburgerkäse (40% Fett i. Tr.) See above 40 128 Münsterkäse Munster-Géromé cheese 45 120 Hard and slicing cheese (Hart- und Schnittkäse), 50-g serving Edamerkäse (30% Fett i. Tr.) (Dutch) Edam cheese 30 256 Edamerkäse (45% Fett i. Tr.) See above 40 230 Gouda Gouda cheese 45 220 Appenzeller Rahmstufe Appenzeller cheese (hard cow milk cheese) Varies 249 Emmentaler Swiss (Emmental) cheese 45 291 Schmelzkäse, 62.5-g serving or 1 wedge (1 Ecke) Schmelzkäse Processed soft (melted) cheesea Varies 590b -
Variations in phosphorus contents reflect mostly the contribution of additives. Contents of the table were developed on the basis of personal communication with Dr. Martin Kuhlmann (Berlin, Germany). English translation of the German words: Käse, cheese; Weich, soft; Hart, hard; Schmelz, melt (Schmelzkäse usually referrers to “processed” soft cheese); Ecke, wedge; Fett i. Tr., fat in dry matter.
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↵a There are different brands of processed soft cheese in the United States, such as Velveeta.
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↵b For the processed soft cheese, the serving unit is 62.5 g (equivalent of 472 mg in 50 g of processed cheese).
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In this issue
Jump to section
- Article
- Abstract
- The Element Phosphorus
- Dietary P and its Metabolism
- Organic P and Dietary Protein
- P Intake from Plant Foods: The Role of Phytate
- Inorganic P in Additives
- Implications of P Burden from Additives
- Balancing Dietary Protein and P Intake in CKD
- Metrics for Dietary P Management in CKD: P-to-Protein Ratio
- Conclusions
- Disclosures
- Acknowledgments
- Footnotes
- References
- Figures & Data Supps
- Info & Metrics
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- Potassium Homeostasis, Chronic Kidney Disease, and the Plant-Enriched Diets
- Elevated phosphate mediates extensive cellular toxicity: from abnormal proliferation to excessive cell death
- Lack of Awareness of Dietary Sources of Phosphorus Is a Clinical Concern
- Phosphorus binders: The new and the old, and how to choose
- Phosphate Additive Avoidance in Chronic Kidney Disease
- Nutrition in Cardioskeletal Health
- Rationale and Approaches to Phosphate and Fibroblast Growth Factor 23 Reduction in CKD
- Experimental and regional variations in Na+-dependent and Na+-independent phosphate transport along the rat small intestine and colon
- Lower bioavailability of plant-derived phosphorus
- Increasing Dietary Phosphorus Intake from Food Additives: Potential for Negative Impact on Bone Health
- A Patient with CKD and Poor Nutritional Status
- Effects of Phosphate Binders in Moderate CKD
- Acute Effects of Very-Low-Protein Diet on FGF23 Levels: A Randomized Study
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