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

Autor(es)

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

• Tipo de documento: Artigo Científico
• Fonte: European Journal of Clinical Nutrition; v. 74, p. 7-pg., 2020-09-01.

Resumo

Background/objectives Diet can affect the acid-base status depending on the balance between the intake of acid-inducing foods and base-inducing foods. The purpose of this study was to estimate the dietary acid load and evaluate its association with serum bicarbonate in patients with stages 3 and 4 chronic kidney disease. Subjects/methods One hundred adults (aged >= 20 years) with chronic kidney disease (CKD) stages 3 and 4 were enrolled in a cross-sectional study. A food diary was used to estimate the animal and plant protein intakes, which were used in the potential renal acid load (PRAL) formula described by Remer and Manz. PRAL was divided into quartiles. Regression models unadjusted and adjusted for age, gender, body mass index, diabetes, systolic and diastolic blood pressure, creatinine clearance were performed using the stepwise regression method. Results The median level (25th, 75th percentiles) of PRAL was 8.3 mEq/day (1.6, 15.6). The highest quartile of PRAL had a higher consumption of animal protein (77.8 +/- 10.9%) and a reduced consumption of plant protein (22.2 +/- 10.9%), compared to the lowest quartile (59.5 +/- 18.6% animal protein, 40.5 +/- 18.6% plant protein), p for trend <0.0001. In the adjusted analysis, a significant association was observed between the highest quartile of PRAL and serum bicarbonate in CKD patients compared to the lowest quartile (beta: 2.07, 95% CI: 0.21-3.92). According to the multiple linear regression, for each increase of 1 unit of PRAL there was a reduction of 0.25 mmol/L in serum bicarbonate (HCO3). Using the stepwise method, animal protein intake and PRAL were determinants of HCO3 (r = 0.49). Conclusions In CKD patients of stages 3 and 4, the dietary acid load was associated with HCO3. Limiting dietary acid load could be a complementary approach in the dietary treatment of CKD. In addition, studies are needed to analyze the effect of replacing animal protein with plant protein. (AU)

• Processo FAPESP: 12/19475-6 - Ingestão proteica para o equilíbrio ácido básico em pacientes nos estágios 3 e 4 da Doença Renal Crônica
• Beneficiário: Larissa Rodrigues Neto Angéloco Lourenço
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto