Dec 09 2024

New Findings Using Dietary Acid Load as an Indicator

More than 340,000 patients in Japan are undergoing dialysis1 for end-stage renal failure, and the number is increasing every year. Dialysis patients are susceptible to malnutrition and frailty, both of which are related to their risk of mortality, making dietary therapy an urgent issue. For patients with chronic kidney disease (CKD) who are not on dialysis, recent guidelines have recommended dietary therapy to reduce acid load by increasing the dietary intake of alkaline foods, such as fruits and vegetables. However, few studies with dialysis patients have considered this.

In the Department of Clinical Nutrition Science at the Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, a research group including TANAKA Mai (graduate student), Specially Appointed Lecturer KABASAWA Hideyuki, and Specially Appointed Associate Professor HOSOJIMA Michihiro investigated the relationship between potential renal acid load (PRAL), an index of dietary acid load 2, and 10-year mortality risk in hemodialysis patients. The results suggested that high PRAL levels are associated with increased risk of mortality in hemodialysis patients and that low intake of fruits and vegetables may be related to high PRAL levels.

Key points

• A high dietary acid load was shown to potentially increase the risk of mortality in hemodialysis patients.
• High dietary acid load was associated with low intake of fruits and vegetables.

[Term explanations]

1.Dialysis
Dialysis is a renal replacement therapy for patients with end-stage renal failure whose kidneys no longer work adequately. Dialysis takes the place of the kidneys and purifies the blood by removing waste products and excess fluid. In general, patients visit a dialysis facility and undergo treatment for 3 to 5 hours, 3 times a week.

2.Dietary acid load
Acid-base balance in the body is affected by diet. The amount of acid in the diet is called the dietary acid load, which can be calculated using information about a person’s diet. This study used PRAL, which is a commonly used index for quantifying dietary acid load.

Publication Details

Journal: Journal of Renal Nutrition
Title: Association between Potential Renal Acid Load and 10-Year Mortality in Patients on Hemodialysis
Authors: Mai Tanaka, Michihiro Hosojima, Hideyuki Kabasawa, Shin Goto, and Ichiei Narita
Doi: 10.1053/j.jrn.2024.11.001