If you are suffering from Chronic Kidney Disease (CKD), or are undergoing dialysis treatment, your doctor may have prescribed you a medicine called 'Phosphate Binders'. You may be wondering, "What is this medicine? Why do I need to take this?" Don't be afraid. Today, we will talk about this in a very simple, understandable, and friendly way.
Let's first see, what is this 'phosphate'?
Simply put, phosphate is an essential mineral for our bodies. Just as we need cement and bricks to build a house, we also need phosphate to build healthy bones and teeth, to produce energy for our cells, and to make the DNA molecules that contain our genetic information. We get these from the things we eat and drink.
In a healthy person, the kidneys work like a filter. They take in the amount of phosphate the body needs and excrete the excess in the urine. However, in a person with chronic kidney disease, this function of the kidneys is impaired. Then , the excess phosphate starts to accumulate in the blood instead of being excreted from the body. We call this condition hyperphosphatemia.
So what are these phosphate binders?
Okay, now comes the important part. Phosphate binders are a special type of medication that stops the excess phosphate in the food we eat from being absorbed into our bloodstream from our intestines.
Think of it this way. When you take this medicine while eating, it goes into your stomach and sticks to the phosphate particles in your food. It's like a magnet picking up iron powder. This "bound" phosphate, because it can't be absorbed by the body, is passed out of your body directly in your stool. This helps control the amount of phosphate that accumulates in your blood.
When phosphate levels in the blood increase, they combine with calcium in the body and weaken our bones. What's even more dangerous is that they can deposit on the walls of blood vessels and block them. This increases the risk of serious conditions like heart disease and stroke.
What foods are high in phosphate? Let's be aware of these too!
Just like taking medication, it is also important to be aware of and control foods that are high in phosphate. The table below lists some foods that are high in phosphate. You don't need to completely avoid these, but it is important to control the amount you eat, with the advice of your doctor or nutritionist.
| Food category | Examples |
|---|---|
| Milk and milk products | Milk, yogurt, cheese (especially processed cheese) |
| Processed foods and fast foods | Sausages, meatballs, ham, bacon, instant noodles |
| Nuts and legumes | Cashews, peanuts, lentils, chickpeas, green beans |
| Carbonated drinks like soda | Dark-colored soft drinks like cola |
| Floury cereals | Buckwheat, oats, rice with bran |
How to use this medicine?
This is the most important thing you should be concerned about. It is imperative that you follow your doctor's instructions exactly.
These medications should be taken with meals. This is because the phosphate in food needs to be absorbed in the stomach before it can reach the intestines. Depending on the type of medication you are taking, your doctor may advise you to:
- Chew and swallow food 10-15 minutes before eating.
- Chew and swallow as soon as you start eating.
- Swallow the tablet whole with the first two or three mouthfuls of food.
- If it's a powder, dissolve it in water and drink it with the first two or three mouthfuls of food.
- Chew and swallow as soon as you finish eating.
You should definitely tell your doctor about any other medications you are taking (vitamins, medications for other illnesses), as some medications may interact with these phosphate binders.
Do phosphate binders have side effects?
Like any medicine, this one can have minor side effects. Most of the time, these are not serious. After a while, your body gets used to it.
- Stomach ache
- Nausea and vomiting
- Filling the stomach, filling with gas
- Constipation
- Diarrhea
- Change in stool color (this is normal, don't worry)
- Some calcium-containing binders can increase blood calcium levels.
If these side effects are very bothersome to you or difficult to tolerate, be sure to talk to your doctor about it.
What happens if you stop taking medication without medical advice?
Never do this. If you stop taking this medication suddenly without your doctor's advice, your blood phosphate levels will rise again quickly. You may experience symptoms like these:
- Itching all over the body
- Numbness of the lips and fingertips
- Bone pain, especially in the hips and shoulders
- Lifeless body
- Redness of the eyes
- Increased risk of heart disease and bone fractures
When should I see the doctor again?
If the side effects are severe or do not improve over time, be sure to see your doctor. In addition, sometimes high levels of phosphate in the blood can cause low calcium levels in the body. This is called hypocalcemia. Tell your doctor right away if you have any of the following symptoms:
- Muscle cramps
- Memory problems
- Feeling irritable (Irritability)
- Numbness of the lips, tongue, fingertips, and/or soles of the feet
- Heartbeat abnormalities (Arrhythmia)
Take-Home Message
- Phosphate binders are an essential medication that controls the phosphate levels in the blood of kidney patients.
- Always take this medicine with food, as directed by your doctor .
- Do not stop taking the medication without medical advice for any reason.
- If side effects are severe or if you have symptoms of calcium deficiency (twitching, numbness), tell your doctor immediately.
- As well as medication, controlling your diet high in phosphate is also very important. Talk to your doctor about this.
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