Low Phosphorus Pizza for People With CKD

Pizza is a popular food for a lot of people – and one that you may not want to give up! Finding a low phosphorus pizza is one key to a kidney friendly pizza. We show you what to look for as well as share specific brands that are better for your kidneys, so you can continue to enjoy your favorite foods.

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Phosphorus Additives in Pizza

One of the biggest problems with pizza is that they often have phosphorus additives. In fact, more than half of the pizzas found in the most recent USDA food database contained a phosphorus additive. These are frequently added to the crust to help it rise better, and they can also be found in certain ingredients (meat toppings are the biggest culprit).

Phosphorus additives are particularly harmful because they are absorbed very easily by the body. Excess phosphorus can contribute to hyperparathyroidism, bone and mineral disease, and calcification of arteries and other tissues.

Finding a pizza with no added phosphorus is key to finding a kidney friendly pizza. For frozen pizzas, check the ingredients list for any ingredients that contain “PHOS”.

For take out or restaurant pizza, this gets a little trickier because you’ll need to find the ingredients list online or ask the restaurant about the ingredients in their crust and toppings. Some chain restaurants make this information relatively easy to find on their website.

As an example, below are the ingredients posted for Domino’s pizza crusts. You can see that two of their crusts have phosphates added:

Sodium in Pizza

Sodium is another big culprit of pizza. Many pizza ingredients are high sodium foods: Pizza crust is almost always high in sodium. Cheese is high in sodium. Meat toppings on pizza tend to be very high in sodium. Even some of the vegetable toppings on pizza will be high in sodium (roasted red peppers, olives, pepperoncini, banana peppers, anchovies, etc).

Generally, a food can be considered low in sodium if it has more calories than sodium. I have not been able to find a true low sodium pizza, but I do see a lot of variation in the amount of sodium in pizzas. Some are better than others.

The key to managing sodium in pizza is to manage portion size. For example, take this French Bread Pizza from Stouffers. One serving (which is one of the French bread pizzas) will have 430 calories and 970mg of sodium (also 16g of protein). That’s an excess of 560mg of sodium. It’s a lot, but you can still make a few lower sodium choices throughout your day to ensure that you still meet your goal of less than 2300mg of sodium for the day.

If you eat BOTH of the pizzas in the package, everything doubles. Now you’ve got 1,940mg of sodium in that one meal. It will be difficult to keep your whole day under 2300mg if you’ve already eaten 1,940 of those mg!

Portion size matters. If one pizza isn’t going to fill you up, consider what else you can eat with the pizza to ensure you are full and satisfied after your meal. Most pizzas are light on vegetables, so adding a vegetable to your meal is a great way to bulk up on nutrients. A salad with a kidney friendly salad dressing would be the perfect addition to a pizza meal!

If you are making your own pizza or have some control over the toppings, here are some additional tips:

1. Use less cheese. Many pizza places will let you specify that you want to use less cheese (and you certainly have control over this at home!). Using less cheese will reduce the amount of sodium and protein in the pizza.
2. Skip the meat toppings. Meat toppings like pepperoni, sausage, and bacon are very high in sodium and can add a lot of sodium to pizza. Limiting these toppings will not only cut back on the salt, but will also lower the protein content of your pizza, which can be helpful for anyone following a lower protein diet.  
3. Choose the right veggie toppings. If a veggie topping comes in a jar, then it is probably high in sodium. High sodium veggie toppings include olives, pepperoncini, and roasted red peppers.

Potassium in Pizza

Most pizzas are not considered high in potassium, although many pizza nutrition labels are missing potassium from the label. It does not mean that the pizzas have zero potassium – it just means that the food manufacturer was not required to report the potassium amount. Generally, pizzas that have meat toppings are not required to report the potassium content, but they will still have potassium in them.

If you have kidney disease, check with your dietitian about whether you need to restrict potassium. Many people do not need to restrict their potassium intake, and there are many other reasons that potassium levels may be high.

Protein in Pizza

Pizza can be a high protein food, depending on the toppings and quantity. Cheese is very high in protein, and many meat toppings can add a significant amount of protein. Even the crust will have some protein in it!

For anyone following a lower protein diet, you will want to pay attention to the portion size of pizza and ensure that the protein will fit with your overall goals.

For all individuals with CKD, keep in mind that protein from animal sources tends to be more acidic. You don’t need to completely eliminate all animal protein from your diet, but if you are planning to enjoy pizza with real cheese or meat toppings, then you may want to consider balancing it out with choosing more plant based foods and proteins for the rest of the day.

Lack of fiber and veggies

While pizza can be delicious, it tends to be lacking in some key elements of a kidney friendly meal: vegetables and fiber! Even if you buy a pizza with veggie toppings, it is usually not enough vegetables to actually count as a full serving of vegetables.

Getting adequate vegetables and fruit is extremely important in a kidney eating plan. They contain valuable nutrients and antioxidants that can help reduce inflammation and acidosis in the body. They also contain fiber, which helps support your gut health AND helps your body control potassium levels.

To help balance out your meal, think about how you can include more vegetables with your meal. Do you want to enjoy a salad while you’re pizza is in the oven? Or perhaps dip some raw veggies in hummus or kidney friendly ranch dressing while you wait for the pizza timer to go off? Or maybe you prefer cooked vegetables and want to roast some carrots or broccoli to serve alongside your pizza. The most important thing is to ensure you get enough veggies in!

Is cauliflower crust pizza good for CKD?

Many pre-made cauliflower crust pizzas contain phosphorus additives. If you find one that doesn’t contain a phosphorus additive, take a close look at the ingredient list. In the ingredient list below, you’ll notice that the crust is made up of a whole lot of other things besides cauliflower.

If most of the crust was actually cauliflower, I would expect to see a lot more fiber in this pizza. Given all the extra ingredients and the relatively low amount of fiber, we can assume that there is probably not that much cauliflower in this crust. You would still want to add some additional servings of vegetables to your meal.

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Low Phosphorus Pizzas You Can Buy

These pizzas contain no phosphorus additives, and include some gluten free and vegan options (if that’s your preference). They may still be high in sodium or protein, so be sure to compare options and serving sizes to find something that fits with your goals. If you want to make a pizza yourself, check out our pizza crust grocery food guide.

Against the Grain Pizza

• Calories: 400
• Protein: 14g
• Carbohydrate: 36g
• Fat: 20g
• Sodium: 440mg
• Phosphorus
  Additives: None
• Potassium: 227mg
• Calcium: 353mg
• Fiber: 0g
• Sugar: 3g

These gluten free pizzas contain no added phosphates and appear to be one of the lowest sodium options. They also make a cheese pizza that appears to have less sodium than calories – so perhaps the only low sodium pizza option I’ve seen. A word of caution though – the nutrition information varied quite a bit depending on what website I checked, so definitely be sure to check the label before purchasing. Click the link below to check prices and read reviews.

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365 Whole Foods Pizza

• Calories: 310
• Protein: 14g
• Carbohydrate: 29g
• Fat: 16g
• Sodium: 690mg
• Phosphorus
  Additives: None
• Potassium: 190mg
• Calcium: 290mg
• Fiber: 2g
• Sugar: 1g

Whole Foods has several store brand frozen pizzas that contain no added phosphates, making them low phosphorus pizzas. The sodium content varies quite a bit, so keep that in mind when choosing a flavor. For example, adding pepperoni to the pizza drives the sodium up quite a bit. They also have a vegan pizza option. Additionally, there are rising crust pizza options with no phosphates added. Click the link below to check prices and read reviews.

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American Flatbread Pizza

• Calories: 360
• Protein: 17g
• Carbohydrate: 45g
• Fat: 12g
• Sodium: 820mg
• Phosphorus
  Additives: None
• Potassium: 180mg
• Calcium: 320mg
• Fiber: 3g
• Sugar: 4g

American Flatbread makes several pizzas that contain no added phosphates. Be sure to read food labels though since some of their varieties (such as their vegan pizza) do contain phosphate additives. Click the link below to check prices and read reviews.

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Amy’s Margherita Pizza

• Calories: 280
• Protein: 10g
• Carbohydrate: 31g
• Fat: 13g
• Sodium: 530mg
• Phosphorus
  Additives: None
• Potassium: 160mg
• Calcium: 130mg
• Fiber: 2g
• Sugar: 4g

Amy’s makes a variety of frozen meals that contain no added phosphorus, and are typically not outrageous when it comes to sodium content. They also have vegan and gluten free low phosphorus pizza options. Be sure to always check labels as occasionally some pizza flavors may contain a phosphate additive (for example, their veggie crust flavor). Click the link below to check prices and read reviews.

Target Good & Gather Spinach and Goat Cheese Pizza

• Calories: 310
• Protein: 14g
• Carbohydrate: 31g
• Fat: 15g
• Sodium: 560mg
• Phosphorus
  Additives: None
• Potassium: 160mg
• Calcium: 310mg
• Fiber: 3g
• Sugar: 4g

Target has several store brand pizzas that contain no phosphorus additives (although some do have them, so always check the labels). Throughout my searches, I came across many store brand pizzas that appeared phos-free, but many of these stores do not have websites for me to verify. So be sure to check your local store brands – you might be pleasantly surprised to find a suitable option. Target also has a gluten free low phosphorus pizza option and a cauliflower pizza with no added phosphates. Avoid the self rising pizzas as those will contain additives. Click the link below to check prices and read reviews.

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Cappello’s Pizza

• Calories: 340
• Protein: 11g
• Carbohydrate: 22g
• Fat: 24g
• Sodium: 710mg
• Phosphorus
  Additives: None
• Calcium: 260mg
• Fiber: 3g
• Sugar: 3g

Capello’s Pizzas are all gluten free, grain, free, so free, and yeast free. Their crust is made of almond flour. Many of them also contain no added phosphates. Click the link below to check prices and read reviews.

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DiGiorno Four Cheese Pizza

• Calories: 300
• Protein: 13g
• Carbohydrate: 37g
• Fat: 10g
• Sodium: 690mg
• Phosphorus
  Additives: None
• Potassium: 150mg
• Calcium: 240mg
• Fiber: 2g
• Sugar: 6g

DiGiorno makes several pizzas with no added phosphates. Surprisingly, their rising crust pizza did not have any phosphates. Typically rising crust pizzas will contain baking powder to make the crust rise, which is a phosphorus additive. Although many of their pizzas do not contain phosphorus additives, many of them do. Always check the ingredient labels. Click the link below to check prices and reviews.

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Home Run Inn Pizza

• Calories: 400
• Protein: 16g
• Carbohydrate: 37g
• Fat: 22g
• Sodium: 810mg
• Phosphorus
  Additives: None
• Potassium: 230mg
• Calcium: 360mg
• Fiber: 2g
• Sugar: 2g

Home Run Inn makes a few pizza options that contain no added phosphates. Be sure to always check the label to verify ingredients as some flavors may contain additives. Click the link below to check prices and read reviews.

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Red Barron Pizza

• Calories: 380
• Protein: 15g
• Carbohydrate: 39g
• Fat: 18g
• Sodium: 810mg
• Phosphorus
  Additives: None
• Potassium: 310mg
• Calcium: 390mg
• Fiber: 2g
• Sugar: 8g

Red Barron makes several types of pizza with no phosphorus additives, however some of their pizza will contain additives. Always check the labels. Click the link below to check prices and reviews.

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Screamin Sicilian Pizza

• Calories: 360
• Protein: 17g
• Carbohydrate: 31g
• Fat: 18g
• Sodium: 720mg
• Phosphorus
  Additives: None
• Potassium: 251mg
• Calcium: 311mg
• Fiber: 2g
• Sugar: 3g

Screamin Sicilian makes a variety of pizzas that contain no added phosphorus (although a few did, especially those with sausage). Always check the ingredient lists. Click the link below to check prices and reviews.

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Stouffer’s French Bread Pizza

• Calories: 430
• Protein: 18g
• Carbohydrate: 41g
• Fat: 21g
• Sodium: 1040mg
• Phosphorus
  Additives: None
• Potassium: 280mg
• Calcium: 240mg
• Fiber: 2g
• Sugar: 4g

Stouffer’s makes a few flavors of pizza with no added phosphates, although they are a bit higher in sodium than some other options. Click the link below to check prices and reviews.

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Udi’s Gluten Free Pizza

• Calories: 350
• Protein: 15g
• Carbohydrate: 33g
• Fat: 18g
• Sodium: 790mg
• Phosphorus
  Additives: None
• Potassium: 280mg
• Calcium: 360mg
• Fiber: 2g
• Sugar: 5g

If you need a gluten free pizza that also contains no phosphorus additives, then check out Udi’s. They are a well known brand in the gluten free space. Click the link below to check prices and reviews.

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