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The vet hasn't said anything about phosphorus binders.  She has said she wants to be proactive. What she mentioned to me was concerns about sodium in his food.   I am familiar with www.felinecrf.org.  If nothing else, he's switching to the lowest phosphorus and sodium version of Fancy Feast...

Yes, I've tried that he won't eat it.   Pate is too smooth or something for him.  I think it needs very small distinct chunks or something.  

Let me start off by saying that I *know* Fancy Feast Elegant Medleys are not very good food.  However, at one point my cat Cleo was just not eating, and the vet said to try anything including canned tuna or chicken to get him eating again.  They were they only thing he would touch.  He got much...