| Summary: | Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, and limiting dietary phosphate intake, but treatment barriers are poor patient compliance and low health literacy arising from low self-efficacy and lack of educational resources. This study describes developing and validating a phosphate mobile application (PMA). The PMA development based on the seven-stage <i>Precaution Adoption Process Model</i> prioritized titrating dietary phosphate intake with phosphate binder dose supported by educational videography. Experts (<i>n</i> = 13) first evaluated the PMA for knowledge-based accuracy, mobile heuristics, and clinical value. Adult HD patients validated the improved PMA using the seven-point mHealth App Usability Questionnaire (MAUQ). Patient feedback (<i>n</i> = 139) indicated agreement for <i>ease of use</i> (69.2%), <i>interface and satisfaction</i> (69.0%), and <i>usefulness</i> (70.1%), while 72.7% said they would <i>recommend</i> this PMA. The <i>expectation confirmation</i> for 25 PMA features ranged from 92.1% (<i>lifestyle</i>) up to 100.0% (<i>language option</i>); and the utilization rate of each feature varied from 21.6% (<i>goal setting</i> and <i>feature-based log</i>) to 91.4% (<i>information</i> on <i>dietary phosphate</i> and <i>phosphate binder</i>). The Conclusions: <i>MyKidneyDiet-Phosphate Tracker</i> PMA was acceptable to adult Malaysian HD patients as part of clinical phosphate management in low-resource settings.
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