Which statement about phosphorus restriction in CKD is correct?

• A. It helps prevent secondary hyperparathyroidism and vascular calcification
• B. It has no impact on bone health
• C. It worsens edema and fluid retention
• D. It increases the risk of hyperkalemia

Answer: (A)

Phosphorus restriction in CKD targets the high phosphate level that results from reduced kidney excretion. When serum phosphate stays elevated, the parathyroid gland increases parathyroid hormone production, leading to secondary hyperparathyroidism. This hormone drives bone resorption and contributes to renal bone disease, and high phosphate levels also promote vascular calcification, which raises cardiovascular risk. By limiting phosphorus intake and using phosphate binders when needed, phosphate levels stay lower, which reduces PTH stimulation and helps protect both bone health and vascular tissues.

The statement captures this protective effect on both secondary hyperparathyroidism and vascular calcification. The other options don’t fit because dietary phosphorus restriction does impact bone health by reducing bone turnover and mineral loss; it isn’t known for worsening edema or directly affecting fluid retention, and it doesn’t increase the risk of hyperkalemia.