Kidney Week

Abstract: SA-PO493

Association of Dietary Acid Load and Its Dietary Sources with Aciduria in Community-Dwelling Japanese Adults

Session Information

• Acid-Base, Calcium, Potassium, and Magnesium Disorders: Clinical
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid, Electrolytes, and Acid-Base Disorders

• 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

• Kabasawa, Keiko, Niigata University, Niigata, Japan

Keiko Kabasawa, MD, PhD, MPH

• Hosojima, Michihiro, Niigata University, Niigata, Japan

Michihiro Hosojima, MD, PhD

• Kabasawa, Hideyuki, Niigata University, Niigata, Japan

Hideyuki Kabasawa, MD, PhD

• Takachi, Ribeka, Nara Women's University, Nara, Japan

Ribeka Takachi, PhD, RD

• Nakamura, Kazutoshi, Niigata University, Niigata, Japan

Kazutoshi Nakamura

• Tanaka, Junta, Niigata University, Niigata, Japan

Junta Tanaka, MD, PhD

• Narita, Ichiei, Niigata University, Niigata, Japan

Ichiei Narita, MD, PhD

• Ito, Yumi, Niigata University, Niigata, Japan

Yumi Ito, MD, PhD

Background

The composition of certain diets, such as contemporary Western diets, leads to chronic subclinical metabolic acidosis, which can lead to urine acidification. Methods for estimating dietary acid load have been established in Western countries, but such estimates have not been fully evaluated in Asian populations, which have different dietary habits. Here, we evaluated associations of dietary acid load and the corresponding nutrient compositions with aciduria.

Methods

This study was based on data from a Japanese community-based cohort comprising 6,274 adults aged ≥40 years, 51.0% women). We cross-sectionally assessed dietary acid load and aciduria (spot urine pH <6.0). Dietary acid load was estimated by net endogenous acid production (NEAP) score and its components, calculated from energy-adjusted nutrients based on a validated food frequency questionnaire. Associations with aciduria were analyzed by using multivariable logistic regression analysis with adjustment for potential confounders.

Results

Median NEAP and eGFR were 38.8 mEq/day and 74.0 mL/min/1.73m², respectively. Higher NEAP was significantly associated with aciduria (P for trend <0.001, Figure). When intake of dietary protein and protein sources were analyzed separately from potassium, higher potassium intake showed a significant inverse association with aciduria, while relatively high animal protein intake, but not total protein, was positively associated with aciduria (both P for trend <0.05, Figure).

Conclusion

Our findings suggest that estimated diet-dependent net acid load was associated with aciduria, and low potassium intake and relatively high animal protein out of total protein intake may be contributors to aciduria in Japanese community-dwelling adults.

Adjusted odds ratio of aciduria according to each quartile of NEAP and its sources

Funding

• Government Support – Non-U.S.