There is a direct link between hyperphosphatemia and increased mortality in end-stage kidney disease, which can be attributed to the higher consumption of ultra-processed foods. Thus, the study aimed to analyze the total phosphorus content and relative amount of available phosphorus in various manufactured processed foods (MPF) and home processed foods (HPF), specifically for use by dialysis patients. The results of the total phosphorus content were found in the range of (26 to 290 mg P/100g). The highest concentration (290 mg/100g) was found in nan bread (HPF), followed by boiled eggs (255mg/100g), chicken (192mg/100g) and beans (91mg/100g). For MPF samples, the chicken (195mg/100g), whole meal bread (193mg/100g), and wheat and white bread wraps for both Asda and Tesco (99, 124 mg/100 respectively) respectively exhibited high phosphorus content. In this study, relative available P concentrations were in the range of (5-42.5 mg P/100g) for MPF and (6-38 mg P/100g) for HPF. While the highest concentration (42.5 mg/100g) was found in chicken (MPF), followed by whole meal bread, and Coca-Cola. For HPF Nan bread (37.8 mg P/100g) showed high content followed by boiled eggs and Chicken. HPF generally exhibited higher levels of both total phosphorus content and extractable phosphorus compared to manufactured processed foods (MPF). This is an important consideration for patients, particularly those with kidney disease, as they should be mindful of their phosphorus intake when consuming HPF.
Calvo, M.S., & Uribarri, J. (2021). Perspective: plant-based whole-grain foods for chronic kidney disease: the phytate-phosphorus conundrum. Advances in Nutrition, 12(6), 2056-2067. https://doi.org/10.1093/advances/nmab066
Cupisti, A., D’Alessandro, C., Baldi, R., & Barsotti, G. (2004). Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. Journal of Renal Nutrition, 14(4), 220-225. https://doi.org/10.1053/j.jrn.2004.07.006
EFSA Panel on Food Additives and Flavourings (FAF), Younes, M., Aquilina, G., Castle, L., Engel, K.H., Fowler, P., ... & Gundert‐Remy, U. (2019). Re‐evaluation of phosphoric acid–phosphates–di‐, tri‐and polyphosphates (E 338–341, E 343, E 450–452) as food additives and the safety of proposed extension of use. EFSA Journal, 17(6), e05674. https://doi.org/10.2903/j.efsa.2019.5674
Erem, S., & Razzaque, M.S. (2018). Dietary phosphate toxicity: an emerging global health concern. Histochemistry and Cell Biology, 150(6), 711-719. https://doi.org/10.1007/s00418-018-1711-8
Fukagawa, M., Komaba, H., & Miyamoto, K.I. (2011). Source matters: from phosphorus load to bioavailability. Clinical Journal of the American Society of Nephrology, 6(2), 239-240. https://doi.org/10.2215/CJN.11051210
González-Parra, E., Gracia-Iguacel, C., Egido, J., & Ortiz, A. (2012). Phosphorus and nutrition in chronic kidney disease. International Journal of Nephrology, 2012(1), 597605. https://doi.org/10.1155/2012/597605
Hifizah, A. (2011). In Vitro Phosphorus Solubility Test of Different Sources of Phosphorus. Jurnal Ilmu dan Teknologi Peternakan, 1(2), 59-67. https://doi.org/10.20956/jitp.v1i2.665
Jastrzębska, A. (2006). Determination of sodium tripolyphosphate in meat samples by capillary zone electrophoresis with on-line isotachophoretic sample pre-treatment. Talanta, 69(4), 1018-1024. https://doi.org/10.1016/j.talanta.2005.12.010
Kalantar-Zadeh, K., Gutekunst, L., Mehrotra, R., Kovesdy, C.P., Bross, R., Shinaberger, C.S., ... & Kopple, J.D. (2010). Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clinical Journal of the American Society of Nephrology, 5(3), 519-530. https://doi.org/10.2215/CJN.06080809
Kestenbaum, B., Sampson, J.N., Rudser, K.D., Patterson, D.J., Seliger, S.L., Young, B., ... & Andress, D.L. (2005). Serum phosphate levels and mortality risk among people with chronic kidney disease. Journal of the American Society of Nephrology, 16(2), 520-528. https://doi.org/10.1681/ASN.2004070602
Kooienga, L. (2007, July). Phosphorus Metabolism and Management in Chronic Kidney Disease: Phosphorus Balance with Daily Dialysis. In Seminars in dialysis (Vol. 20, No. 4, pp. 342-345). Oxford, UK: Blackwell Publishing Ltd. https://doi.org/10.1111/j.1525-139X.2007.00304.x
Kovesdy, C.P., Trivedi, B.K., & Anderson, J.E. (2006). Association of kidney function with mortality in patients with chronic kidney disease not yet on dialysis: a historical prospective cohort study. Advances in Chronic Kidney Disease, 13(2), 183 188. https://doi.org/10.1053/j.ackd.2006.01.005
Metson, G.S., Cordell, D., & Ridoutt, B. (2016). Potential impact of dietary choices on phosphorus recycling and global phosphorus footprints: The case of the average Australian city. Frontiers in Nutrition, 3, 35. https://doi.org/10.3389/fnut.2016.00035
Miller, D.D., Schricker, B.R., Rasmussen, R.R., & Van Campen, D. (1981). An in vitro method for estimation of iron availability from meals. The American Journal of Clinical Nutrition, 34(10), 2248-2256. https://doi.org/10.1093/ajcn/34.10.2248
Moe, S.M., Zidehsarai, M.P., Chambers, M.A., Jackman, L.A., Radcliffe, J.S., Trevino, L.L., ... & Asplin, J.R. (2011). Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clinical Journal of the American Society of Nephrology, 6(2), 257-264. https://doi:10.2215/CJN.05040610
Nielsen, S.S. (2024). Vitamin C determination by indophenol method. In Nielsen's Food Analysis Laboratory Manual (pp. 153-156). Cham: Springer International Publishing.
Noori, N., Sims, J.J., Kopple, J.D., Shah, A., Colman, S., Shinaberger, C.S., ... & Kalantar-Zadeh, K. (2010). Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iranian Journal of Kidney Diseases, 4(2), 89-100.
Okpechi, I.G., Caskey, F.J., Gaipov, A., Tannor, E.K., Noubiap, J.J., Effa, E., ... & Jha, V. (2022). Early identification of CKD—a scoping review of the global populations. Kidney International Reports, 7(6), 1341-1353. https://doi.org/10.1016/j.ekir.2022.03.031
Rosenberg, I.E. (2000). Krause's Food, Nutrition, & Diet Therapy, edited by L. Kathleen Mahan, MS, RD, CDE and Sylvia Escott-Stump, MA, RD, LDN. Journal of Nutrition for The Elderly, 19(4), 66-68.
Sherman, R.A. (2007, January). Dietary phosphate restriction and protein intake in dialysis patients: a misdirected focus. In Seminars in Dialysis (Vol. 20, No. 1, pp. 16-18). Oxford, UK: Blackwell Publishing Ltd. https://doi.org/10.1111/j.1525-139X.2007.00204.x
Shinaberger, C.S., Greenland, S., Kopple, J.D., Van Wyck, D., Mehrotra, R., Kovesdy, C.P., & Kalantar-Zadeh, K. (2008). Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?. The American Journal of Clinical Nutrition, 88(6), 1511-1518. https://doi.org/10.3945/ajcn.2008.26665
Shiowatana, J., Kitthikhun, W., Sottimai, U., Promchan, J., & Kunajiraporn, K. (2006). Dynamic continuous-flow dialysis method to simulate intestinal digestion for in vitro estimation of mineral bioavailability of food. Talanta, 68(3), 549 557. https://doi.org/10.1016/j.talanta.2005.04.068
Sullivan, C., Sayre, S.S., Leon, J.B., Machekano, R., Love, T.E., Porter, D., ... & Sehgal, A.R. (2009). Effect of food additives on hyperphosphatemia among patients with end-stage renal disease: a randomized controlled trial. Jama, 301(6), 629 635. https://doi:10.1001/jama.2009.96
Thongprayoon, C., Kaewput, W., Choudhury, A., Hansrivijit, P., Mao, M.A., & Cheungpasitporn, W. (2021). Is it time for machine learning algorithms to predict the risk of kidney failure in patients with chronic kidney disease? Journal of Clinical Medicine, 10(5), 1121.https://doi.org/10.3390/jcm10051121
Uribarri, J. (2001). DOQI guidelines for nutrition in long-term peritoneal dialysis patients: a dissenting view. American Journal of Kidney Diseases, 37(6), 1313 1318. https://doi.org/10.1053/ajkd.2001.24542
Weremko, D., Fandrejewski, H., Zebrowska, T., Han, I.K., Kim, J.H., & Cho, W.T. (1997). Bioavailability of phosphorus in feeds of plant origin for pigs-Review. Asian-Australasian Journal of Animal Sciences, 10(6), 551-566. https://doi.org/10.5713/ajas.1997.551
Willett, W.C. (2008). Overview and perspective in human nutrition. Asia Pacific Journal of Clinical Nutrition, 17.
Winger, R.J., Uribarri, J., & Lloyd, L. (2012). Phosphorus-containing food additives: An insidious danger for people with chronic kidney disease. Trends in Food Science & Technology, 24(2), 92-102. https://doi.org/10.1016/j.tifs.2011.11.001
Analysis of accessible and total phosphate contents in different foods, to assess their suitability for use by dialysis patients
There is a direct link between hyperphosphatemia and increased mortality in end-stage kidney disease, which can be attributed to the higher consumption of ultra-processed foods. Thus, the study aimed to analyze the total phosphorus content and relative amount of available phosphorus in various manufactured processed foods (MPF) and home processed foods (HPF), specifically for use by dialysis patients. The results of the total phosphorus content were found in the range of (26 to 290 mg P/100g). The highest concentration (290 mg/100g) was found in nan bread (HPF), followed by boiled eggs (255mg/100g), chicken (192mg/100g) and beans (91mg/100g). For MPF samples, the chicken (195mg/100g), whole meal bread (193mg/100g), and wheat and white bread wraps for both Asda and Tesco (99, 124 mg/100 respectively) respectively exhibited high phosphorus content. In this study, relative available P concentrations were in the range of (5-42.5 mg P/100g) for MPF and (6-38 mg P/100g) for HPF. While the highest concentration (42.5 mg/100g) was found in chicken (MPF), followed by whole meal bread, and Coca-Cola. For HPF Nan bread (37.8 mg P/100g) showed high content followed by boiled eggs and Chicken. HPF generally exhibited higher levels of both total phosphorus content and extractable phosphorus compared to manufactured processed foods (MPF). This is an important consideration for patients, particularly those with kidney disease, as they should be mindful of their phosphorus intake when consuming HPF.
Calvo, M.S., & Uribarri, J. (2021). Perspective: plant-based whole-grain foods for chronic kidney disease: the phytate-phosphorus conundrum. Advances in Nutrition, 12(6), 2056-2067. https://doi.org/10.1093/advances/nmab066
Cupisti, A., D’Alessandro, C., Baldi, R., & Barsotti, G. (2004). Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. Journal of Renal Nutrition, 14(4), 220-225. https://doi.org/10.1053/j.jrn.2004.07.006
EFSA Panel on Food Additives and Flavourings (FAF), Younes, M., Aquilina, G., Castle, L., Engel, K.H., Fowler, P., ... & Gundert‐Remy, U. (2019). Re‐evaluation of phosphoric acid–phosphates–di‐, tri‐and polyphosphates (E 338–341, E 343, E 450–452) as food additives and the safety of proposed extension of use. EFSA Journal, 17(6), e05674. https://doi.org/10.2903/j.efsa.2019.5674
Erem, S., & Razzaque, M.S. (2018). Dietary phosphate toxicity: an emerging global health concern. Histochemistry and Cell Biology, 150(6), 711-719. https://doi.org/10.1007/s00418-018-1711-8
Fukagawa, M., Komaba, H., & Miyamoto, K.I. (2011). Source matters: from phosphorus load to bioavailability. Clinical Journal of the American Society of Nephrology, 6(2), 239-240. https://doi.org/10.2215/CJN.11051210
González-Parra, E., Gracia-Iguacel, C., Egido, J., & Ortiz, A. (2012). Phosphorus and nutrition in chronic kidney disease. International Journal of Nephrology, 2012(1), 597605. https://doi.org/10.1155/2012/597605
Hifizah, A. (2011). In Vitro Phosphorus Solubility Test of Different Sources of Phosphorus. Jurnal Ilmu dan Teknologi Peternakan, 1(2), 59-67. https://doi.org/10.20956/jitp.v1i2.665
Jastrzębska, A. (2006). Determination of sodium tripolyphosphate in meat samples by capillary zone electrophoresis with on-line isotachophoretic sample pre-treatment. Talanta, 69(4), 1018-1024. https://doi.org/10.1016/j.talanta.2005.12.010
Kalantar-Zadeh, K., Gutekunst, L., Mehrotra, R., Kovesdy, C.P., Bross, R., Shinaberger, C.S., ... & Kopple, J.D. (2010). Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clinical Journal of the American Society of Nephrology, 5(3), 519-530. https://doi.org/10.2215/CJN.06080809
Kestenbaum, B., Sampson, J.N., Rudser, K.D., Patterson, D.J., Seliger, S.L., Young, B., ... & Andress, D.L. (2005). Serum phosphate levels and mortality risk among people with chronic kidney disease. Journal of the American Society of Nephrology, 16(2), 520-528. https://doi.org/10.1681/ASN.2004070602
Kooienga, L. (2007, July). Phosphorus Metabolism and Management in Chronic Kidney Disease: Phosphorus Balance with Daily Dialysis. In Seminars in dialysis (Vol. 20, No. 4, pp. 342-345). Oxford, UK: Blackwell Publishing Ltd. https://doi.org/10.1111/j.1525-139X.2007.00304.x
Kovesdy, C.P., Trivedi, B.K., & Anderson, J.E. (2006). Association of kidney function with mortality in patients with chronic kidney disease not yet on dialysis: a historical prospective cohort study. Advances in Chronic Kidney Disease, 13(2), 183 188. https://doi.org/10.1053/j.ackd.2006.01.005
Metson, G.S., Cordell, D., & Ridoutt, B. (2016). Potential impact of dietary choices on phosphorus recycling and global phosphorus footprints: The case of the average Australian city. Frontiers in Nutrition, 3, 35. https://doi.org/10.3389/fnut.2016.00035
Miller, D.D., Schricker, B.R., Rasmussen, R.R., & Van Campen, D. (1981). An in vitro method for estimation of iron availability from meals. The American Journal of Clinical Nutrition, 34(10), 2248-2256. https://doi.org/10.1093/ajcn/34.10.2248
Moe, S.M., Zidehsarai, M.P., Chambers, M.A., Jackman, L.A., Radcliffe, J.S., Trevino, L.L., ... & Asplin, J.R. (2011). Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clinical Journal of the American Society of Nephrology, 6(2), 257-264. https://doi:10.2215/CJN.05040610
Nielsen, S.S. (2024). Vitamin C determination by indophenol method. In Nielsen's Food Analysis Laboratory Manual (pp. 153-156). Cham: Springer International Publishing.
Noori, N., Sims, J.J., Kopple, J.D., Shah, A., Colman, S., Shinaberger, C.S., ... & Kalantar-Zadeh, K. (2010). Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iranian Journal of Kidney Diseases, 4(2), 89-100.
Okpechi, I.G., Caskey, F.J., Gaipov, A., Tannor, E.K., Noubiap, J.J., Effa, E., ... & Jha, V. (2022). Early identification of CKD—a scoping review of the global populations. Kidney International Reports, 7(6), 1341-1353. https://doi.org/10.1016/j.ekir.2022.03.031
Rosenberg, I.E. (2000). Krause's Food, Nutrition, & Diet Therapy, edited by L. Kathleen Mahan, MS, RD, CDE and Sylvia Escott-Stump, MA, RD, LDN. Journal of Nutrition for The Elderly, 19(4), 66-68.
Sherman, R.A. (2007, January). Dietary phosphate restriction and protein intake in dialysis patients: a misdirected focus. In Seminars in Dialysis (Vol. 20, No. 1, pp. 16-18). Oxford, UK: Blackwell Publishing Ltd. https://doi.org/10.1111/j.1525-139X.2007.00204.x
Shinaberger, C.S., Greenland, S., Kopple, J.D., Van Wyck, D., Mehrotra, R., Kovesdy, C.P., & Kalantar-Zadeh, K. (2008). Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?. The American Journal of Clinical Nutrition, 88(6), 1511-1518. https://doi.org/10.3945/ajcn.2008.26665
Shiowatana, J., Kitthikhun, W., Sottimai, U., Promchan, J., & Kunajiraporn, K. (2006). Dynamic continuous-flow dialysis method to simulate intestinal digestion for in vitro estimation of mineral bioavailability of food. Talanta, 68(3), 549 557. https://doi.org/10.1016/j.talanta.2005.04.068
Sullivan, C., Sayre, S.S., Leon, J.B., Machekano, R., Love, T.E., Porter, D., ... & Sehgal, A.R. (2009). Effect of food additives on hyperphosphatemia among patients with end-stage renal disease: a randomized controlled trial. Jama, 301(6), 629 635. https://doi:10.1001/jama.2009.96
Thongprayoon, C., Kaewput, W., Choudhury, A., Hansrivijit, P., Mao, M.A., & Cheungpasitporn, W. (2021). Is it time for machine learning algorithms to predict the risk of kidney failure in patients with chronic kidney disease? Journal of Clinical Medicine, 10(5), 1121.https://doi.org/10.3390/jcm10051121
Uribarri, J. (2001). DOQI guidelines for nutrition in long-term peritoneal dialysis patients: a dissenting view. American Journal of Kidney Diseases, 37(6), 1313 1318. https://doi.org/10.1053/ajkd.2001.24542
Weremko, D., Fandrejewski, H., Zebrowska, T., Han, I.K., Kim, J.H., & Cho, W.T. (1997). Bioavailability of phosphorus in feeds of plant origin for pigs-Review. Asian-Australasian Journal of Animal Sciences, 10(6), 551-566. https://doi.org/10.5713/ajas.1997.551
Willett, W.C. (2008). Overview and perspective in human nutrition. Asia Pacific Journal of Clinical Nutrition, 17.
Winger, R.J., Uribarri, J., & Lloyd, L. (2012). Phosphorus-containing food additives: An insidious danger for people with chronic kidney disease. Trends in Food Science & Technology, 24(2), 92-102. https://doi.org/10.1016/j.tifs.2011.11.001
Wahab, M., & Ahmed, H. M. (2025). Analysis of accessible and total phosphate contents in different foods, to assess their suitability for use by dialysis patients. International Journal of Secondary Metabolite, 12(2), 248-260. https://doi.org/10.21448/ijsm.1459369