Date of publication: October 12, 2017

Medical Education

Nutrition Management and Hyperphosphataemia

Balancing phosphate levels and protein intake in dialysis dependent CKD patients is a significant challenge.[1] Impaired renal phosphate excretion and high protein dietary requirements frequently lead to hyperphosphatemia, which negatively impacts patients’ mineral bone health.[2] The growing elderly dialysis population is particularly challenging to manage due to its additional nutritional requirements.[3]

This downloadable presentation summarises the causes and consequences of the disruption of phosphate homeostasis in CKD. Additionally, it discusses the use of an integrated approach to achieve phosphate control in CKD, with patient education & dietary changes complementing optimized use of dialysis and potent phosphate binders.[1]

This presentation was developed by the COMPACT RENAL editorial team in association with Professor Denis Fouque (Professor of Nephrology at the University Claude Bernard Lyon, and Chief of the Division of Nephrology at the Centre Hospitalier Lyon Sud in Lyon, France). Professor Fouque is a member of the COMPACT RENAL advisory board.

Balance between phosphate and protein


  1. Fouque D, Horne R, Cozzolino M, et al. Balancing Nutrition and Serum Phosphorus in Maintenance Dialysis. Am J Kidney Dis. 2014; 64(1):143-50. doi:10.1053/j.ajkd.2014.01.429.
  2. Vervloet MG, Sezer S, Massy ZA, et al. The role of phosphate in kidney disease. Nat Rev Nephrol. 2017; 13(1):27-38. doi:10.1038/nrneph.2016.164.
  3. Johansson L, Fouque D, Bellizzi V, et al. As we grow old: nutritional considerations for older patients on dialysis. Nephrol Dial Transplant. 2017; 32(7):1127-1136. doi:10.1093/ndt/gfw201.

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  • Again a very ice presentation of all necessary facts and recommendations for a better phosphate and protein management!
    Again: the whole nephrological community should bundle their efforts in convincing patients and politicians of a better and more precise labelling of processed food with regards to phosphate additives and the phosphate to protein ratio. Otherwise the patient/consumer will not be able to choose food items with low phosphate but high protein content.


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