Last week I had my adequacy test along with monthly labs. I noted that my A1c jumped from 5.3 to 6.3, and my phosphorus reading went slightly high rising from 4.8 in June to 5.7 in July.
Explaining my A1c is easy. I was starting to have hypoglycemic events during the night and coupled with higher temps here in North Texas and working outside resulting in lots of sweat I cut back on my insulin from 10 units to 7 at one point. I am gradually increasing my nightly insulin back toward 10 with success thus far. Keep in mind the goal for Type II diabetics is an A1c under 7.0 so I’m still within acceptable range.
My nephrologist and Diatetian were concerned about my Phosphorus increasing and suggested I start chewing a Velphoro, the big brown horse pill that absorbs phosphorus with any large meal, not just breakfast as I had been doing. So that’s what I’m doing now.
With this as a background, I turned to my AI assistant with the following prompt and result to provide us all more insight into just what this Phosphorus thing is all about. Read on ->
w=Write an interesting blog entry about the importance of controlling phosphorus in their diet for a person on peritoneal dialysis
ChatGPT
Title: Phosphorus in Check: The Crucial Role of Dietary Management for Peritoneal Dialysis Patients
While everyone needs a certain amount of phosphorus to maintain their body’s balance and function, those on peritoneal dialysis require a more precise, carefully controlled approach. Phosphorus, an essential mineral found abundantly in many foods, plays an integral part in building strong bones and teeth, aiding muscle function, and maintaining heart rhythm. However, the kidneys often struggle to filter this mineral in individuals with kidney disease, leading to high phosphorus levels in the blood—a condition known as hyperphosphatemia.
When it comes to dialysis, particularly peritoneal dialysis, excess phosphorus in the diet can cause several complications, ranging from calcification of organs and blood vessels to bone disease, heart disease, and even an increased risk of mortality. This makes dietary phosphorus control a key aspect of the healthcare strategy for individuals undergoing this treatment.
A Delicate Balance
The average person typically consumes more phosphorus than the body needs. However, in the case of peritoneal dialysis patients, the inability of their kidneys to remove excess phosphorus necessitates restrictions. While dialysis helps remove some phosphorus, it cannot remove as much as healthy kidneys would. This imbalance may lead to an overabundance of phosphorus in the blood, creating potential health hazards.
Effects of High Phosphorus Levels
One of the most significant health risks is the development of bone disease. Too much phosphorus can lead to lower calcium levels in the blood, stimulating the release of parathyroid hormone (PTH). High PTH levels can cause calcium to be drawn from the bones, weakening them over time—a condition known as renal osteodystrophy.
Additionally, excess phosphorus can bind with calcium in the blood, creating deposits that can stiffen and clog blood vessels—a process known as vascular calcification. This can lead to increased blood pressure and an elevated risk of heart disease, the leading cause of death in individuals with chronic kidney disease.
The Diet Factor
To minimize these risks, it’s essential to control dietary phosphorus. While it’s found in nearly all foods, it’s especially abundant in protein-rich foods like meats, poultry, fish, dairy products, beans, and nuts, as well as processed foods and drinks, which often contain added phosphates.
A dietitian can provide an individualized meal plan to keep phosphorus intake in check. The plan may involve consuming smaller portions of high-phosphorus foods, choosing foods with lower phosphorus-to-protein ratios, or opting for fresh, unprocessed foods. Some people may also need phosphorus binders, medications that help prevent phosphorus absorption.
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