Hi,

Could you please clarify something for me. According to this link,

http://en.wikipedia.org/wiki/Phosphate_binders



anyone with chronic renal failure tends to have a high phosphorous levels,and low calcium levels due to the kidneys not being able to product the active form of Vitamin D which aids in calcium absorption from food. They suggest giving phosphate binders, Vitamin D, and extra calcium.



What form of calcium can be given that does not contain phosphorous? Bone meal does. So does calcium from oyster shells. I can't seem to find a source of calcium that doesn't contain phosphorous.



According to this link:



www.oralchelation.com/ingred/phosphorus.htm



"The increased urinary excretion of phosphorus is advantageous in bringing blood calcium levels up to normal because high blood levels of phosphate suppress the conversion of vitamin D to its active form in the kidneys."



A phosphate binder would cause phosphorous to be bound and excreted which would raise blood calcium levels but also according to information on phosphate binders, they are forms of antiacids and will bring the calcium levels up because that's what they do. Giving calcium when all this is happening, would it lead to too much calcium being given or is there the chance of blood calcium levels getting too high by a person giving calcium as well as a phosphate binder?



If one has the active form of Vitamin D is it possible to give it and would it help. or in giving a phosphate binder there's no need to also give the active form of Vitamin D because Vitamin D will convert to its active form in the kidneys once the blood levels of phosphate are controlled>? Or, with chronic renal failure the kidneys won't ever convert Vitamin D to its active form so would it be a good idea to give the active form of Vitamin D? If so, how much? How much calcium?



I find that most foods cats eat contain high levels of phosphorous. Meat. Even eggs. My cat likes to eat hard boiled eggs and macaroni and tomatoes. Both contain phosphorous. Even with a phosphate binder (aluminum hydroxide-500 mg divided into four pieces, one piece every 12 hours).



I'm wondering about whether I should be giving calcium(if so in what form) and Vitamin D. How does one balance the phosphorous and calcium levels when one feeds meat to their cats, even if restricted it's still high in phosphorous. The yogurt I was giving for digestive enzymes was also high in phosphorous so I stopped giving it. Eggs and macaroni has fairly high phosphorous.Will giving a phosphate binder balance all of this or is more needed to do so, ie, giving extra calcium and Vitamin D? Thank you for any ideas you may have concerning this.

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