title: Dietary Acid-Base Load and Risk of Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study.
abstract: BACKGROUND
  The objective was to examine whether dietary acid load was associated with chronic kidney disease (CKD) in adults.
  
  
  METHODS
  The cross-sectional analyses included 4564 participants, aged 20 years and older, who participated in the 4th phase of the Tehran Lipid and Glucose Study and had complete dietary and serum creatinine data. Dietary data were obtained from using a 147-item food-frequency questionnaire. Dietary acid load was calculated as the potential renal acid load (PRAL). Anthropometrics, blood pressure, and fasting plasma glucose, and lipids were measured. Chronic kidney disease was defined as an estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 calculated using the Modification of Diet in Renal Disease equation. Risk of CKD was obtained in quartiles of PRAL with logistic recreation.
  
  
  RESULTS
  The mean dietary PRAL of the participants was -22.0 mEq/d. After adjustment for age, sex, and body mass index, the odds ratio for CKD in the highest compared to the lowest quartile of PRAL was 1.38 (95% confidence interval [CI], 1.02 to 1.83). After additional adjustment for energy intake and smoking, the odds ratio for CKD in the 4th quartile of PRAL compared to the 1st was 1.42 (95% CI, 1.06 to 1.91). In the final model, after additional adjustment for dietary intake of total fat, carbohydrate, dietary fiber, fructose, sodium, diabetes mellitus, and hypertension, the risk of CKD in the highest dietary PRAL category, compared to the lowest, increased by 42%.
  
  
  CONCLUSIONS
  After adjusting for possible confounding factors, we found that higher PRAL (more acidic diet) was associated with higher prevalent CKD in Iranian adults.
authors.affiliation: Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. mirmiran@endocrine.ac.ir.
authors.forename: Parvin
authors.initials: P
authors.lastname: Mirmiran
authors.forename: Emad
authors.initials: E
authors.lastname: Yuzbashian
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bahadoran
authors.forename: Golaleh
authors.initials: G
authors.lastname: Asghari
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000137:Acid-Base Imbalance / Q000150:complications; D000143:Acids / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D050356:Lipid Metabolism / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000143:Acids; D001786:Blood Glucose