Association of dietary acid load with serum bicarbonate in chronic kidney disease (CKD) patients

Angéloco, Larissa Rodrigues Neto; Souza, Gabriela Cristina Arces de; Romão, Elen Almeida; Frassetto, Lynda; Chiarello, Paula Garcia

doi:10.1038/s41430-020-0689-1

Cited by 11 publications

(4 citation statements)

References 31 publications

(47 reference statements)

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“…In other study (27), mean value of NEAP of CKD patients was 50.1±13.1mEq/day. In Brazilian study (28), the median value of PRAL was 6.8 mEq/day and of NEAP was 53.1 mEq/day for CKD patients. In African American CKD patient (15),Median estimated NEAP was estimated 71 mEq/d.Another study (29) showed that median value of estimated DAL, is 47.24 mEq/d .The study among Venezuelan CKD children (30) indicated that mean of PRAL is 16 ± 10.7 mEq/day.…”

Section: Discussionmentioning

confidence: 84%

“…Because, while the validity ofdietary acidi load values calculated by PRAL formula versus it's measured vale from urine has been con rmed (47,48), due to the limited interpretation of the results obtained from the formulas for estimating the dietary acid load in different situations of urinary pH and blood bicarbonate concentration (28), long-term study with more and more population and taking into account blood bicarbonate concentration and urinary pH is proposed.…”

Section: Discussionmentioning

confidence: 99%

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Dietary Acid Load and Glomerular Filtration Rate in Chronic Kidney Disease

Koor

Mousavizadeh

PourAnsari

et al. 2021

Preprint

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Background: Kidney diseases are prevalencing rapidly. The nutritional transition has caused the diet of Iran community to increase the dietary acid load (DAL) and thus exacerbate metabolic disorders. Therefore, our goal was to determine the DAL of the diet in patients with Chronic Kidney Disease (CKD). Methods: In this cross-sectional study, the study population was composed of 90 patients with renal insufficiency. DAL was included of Potential Renal Acid Load(PRAL), Net EndogeneusAcid Production(NEAP) and Net Acid Excretion(NAE) that were extracted using data of food frequency questionnaire and their correlation with anthropometric and biochemical indices such as Glomerular Filtration Rate (GFR) and creatinine were analyzed by SPSS v.26 software with a significance level of < 0.05.Results: Mean of dietary acid load of participants were 17.15±9.85,-8.7±0.35 and 59.04±10.9 mEq/day for PRAL, NEAP and NAE respectively. Daily intake of energy (P<0.001) and protein percent of energy (P<0.01) in third tertile (T3) of PRAL were significant higher than first tertile (T1). Mean of age (P<0.05) and blood creatinine concentration (P<0.01) were significant higher in T1 than T1 of NEAP index and GFR was significant low (P<0.05). Daily energy intake (p<0.05), blood calcium concentration (p<0.05) and GFR (p<0.05) were significantly more in higher tertiles of NAE index. Based on Crude General linear model, the higher tertiles of PRAL compared to first tertile had significant lower GFR (P<0.05). In adjustment model, T3 group had more not significant GFR than T1 group. Only in model II adjustment, T2 group of NAE compared to T1, had higher GFR. Mean difference of GFR did not significant across tertiles of NEAP index. In case of Creatinine, based on model I adjustment, T3 group of NAE had more creatinine concentration than T1 group (P<0.01). T3 group of NEAP than T1 group had significant lower creatinine in crude and modelI adjustment (P<0.01). Discussion: Dietary Acid Load was associated with kidney function in CKD patients. In order to obtain logical results and to understand the cause-and-effect relationships, long-term studies with larger populations and consideration of blood factors such as blood bicarbonate are recommended.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Dietary Acid Load and Glomerular Filtration Rate in Chronic Kidney Disease

Koor

Mousavizadeh

PourAnsari

et al. 2021

Preprint

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“…Western diets typically consist of large amounts of animal protein and processed foods, which produce a high dietary acid load (DAL). In comparison, vegetarian/vegan diets with high fruit and vegetable content are often low in acid load and high in potassium bases, which can result in a net alkali load [ 8 , 61 ]. In recent years, the impact of DAL on health and disease has gained increasing recognition [ 20 , 113 , 143 , 154 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary acid load in health and disease

Wieërs,

Beynon-Cobb,

Visser

et al. 2024

Pflugers Arch - Eur J Physiol

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Maintaining an appropriate acid–base equilibrium is crucial for human health. A primary influencer of this equilibrium is diet, as foods are metabolized into non-volatile acids or bases. Dietary acid load (DAL) is a measure of the acid load derived from diet, taking into account both the potential renal acid load (PRAL) from food components like protein, potassium, phosphorus, calcium, and magnesium, and the organic acids from foods, which are metabolized to bicarbonate and thus have an alkalinizing effect. Current Western diets are characterized by a high DAL, due to large amounts of animal protein and processed foods. A chronic low-grade metabolic acidosis can occur following a Western diet and is associated with increased morbidity and mortality. Nutritional advice focusing on DAL, rather than macronutrients, is gaining rapid attention as it provides a more holistic approach to managing health. However, current evidence for the role of DAL is mainly associative, and underlying mechanisms are poorly understood. This review focusses on the role of DAL in multiple conditions such as obesity, cardiovascular health, impaired kidney function, and cancer.

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“…[6][7][8][9][10] The potential benefits of restricting animal protein are many and include reducing the daily acid load, improving bicarbonate and phosphorus levels, and attenuating glomerular hyperfiltration and albuminuria. [11][12][13][14][15][16][17][18][19][20][21] In most cases, dietary protein restriction involves reducing animal protein intake and, by default, sulfur intake. Hence, protein restriction may have adverse effects on sulfur metabolism and patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Urinary Sulfate, Kidney Failure, and Death in CKD: The African American Study of Kidney Disease and Hypertension

et al. 2022

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Background: Sulfur is an important mineral element whose principal source is animal protein. Animal protein contributes to the daily acid load, which is associated with poor outcomes in individuals with chronic kidney disease (CKD). We hypothesized that higher urinary sulfate, as a reflection of the daily acid load, is associated with a greater risk of death and CKD progression. Methods: Urinary sulfate was measured in 1057 African American Study of Kidney Disease and Hypertension (AASK) participants at baseline. Participants were categorized by tertiles of daily sulfate excretion. The longitudinal outcome of interest was the composite of death, dialysis, or 50% reduction in measured glomerular filtration rate (GFR). Multivariable adjusted Cox regression models were fit to relate the composite outcome to daily sulfate excretion using the lowest tertile as the reference. Results: Participants in the highest urinary sulfate tertile were more likely to be male and have higher body mass index, protein intake, measured GFR, and urinary ammonium and phosphate excretion, and lower urinary protein/creatinine. Compared to those in the lowest tertile of sulfate, those in the highest tertile had 44% lower hazard (95% CI, 0.37-0.84) and those in the middle tertile had 27% lower hazard (95% CI, 0.55-0.96) of death, dialysis or 50% reduction in measured GFR during follow-up after adjusting for demographics, GFR, protein intake and other potential confounders. Protein intake was not associated with risk of these events. Conclusions: Higher urinary sulfate excretion is associated with more favorable outcomes in African Americans who have CKD attributed to hypertension.

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Association of dietary acid load with serum bicarbonate in chronic kidney disease (CKD) patients

Abstract: Association of dietary acid load with serum bicarbonate in chronic kidney disease (CKD) patients.

Cited by 11 publications

References 31 publications

Dietary Acid Load and Glomerular Filtration Rate in Chronic Kidney Disease

Dietary Acid Load and Glomerular Filtration Rate in Chronic Kidney Disease

Dietary acid load in health and disease

Urinary Sulfate, Kidney Failure, and Death in CKD: The African American Study of Kidney Disease and Hypertension

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