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Abstract: SA-PO1037

Association Between Estimated Dietary Acid Load and Albuminuria in Japanese Adults

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical


  • Kabasawa, Keiko, Niigata University, Niigata, Japan
  • Hosojima, Michihiro, Niigata University, Niigata, Japan
  • Ito, Yumi, Niigata University, Niigata, Japan
  • Kabasawa, Hideyuki, Niigata University, Niigata, Japan
  • Takachi, Ribeka, Nara Women's University, Niigata, Japan
  • Nakamura, Kazutoshi, Niigata University, Niigata, Japan
  • Saito, Akihiko, Niigata University, Niigata, Japan
  • Tanaka, Junta, Niigata University, Niigata, Japan
  • Narita, Ichiei, Niigata University, Niigata, Japan

Acid-base imbalance might promote the progression of chronic kidney disease (CKD). Albuminuria is a risk factor for cardiovascular disease and mortality even in the high normoalbuminuric range and is also one of the diagnostic markers for CKD. However, the exact relationship between dietary acid load and albuminuria is unclear. In this study, we assessed the association of dietary acid load with albuminuria in Japanese adults.


Subjects were a Japanese cohort comprising 3,202 men and 3,429 women (age range 40-97 years); subjects with a urine albumin-to-creatinine ratio (UACR) ≥ 300 mg/g or eGFR < 15 mL/min/1.73 m2 were excluded. We performed a cross-sectional analysis of net endogenous acid production (NEAP) score and the presence of low-grade albuminuria. NEAP score was derived from nutrient intake based on food frequency questionnaire assessment. Low-grade albuminuria, evaluated using UACR from spot urine samples, was defined as high normoalbuminuria (UACR: 10-29 mg/g) or microalbuminuria (UACR: 30-299 mg/g).


Median NEAP was 43.3 (interquartile range: 34.2, 53.4) mEq/d in men and 35.1 (27.7, 43.7) mEq/d in women. Median UACR and eGFR were 9.6 (5.0, 22.0) mg/g and 73.8 (64.1, 84.3) mL/min/1.73 m2 in men and 13.0 (7.2, 25.0) mg/g and 73.7 (64.7, 83.7) mL/min/1.73 m2 in women, respectively. High normoalbuminuria and microalbuminuria were found in 976 and 616 men and 1,449 and 703 women, respectively. After adjusting for potential confounders, such as diabetes mellitus, the odds ratio of the highest versus lowest NEAP quartile for the presence of high normoalbuminuria and microalbuminuria was 1.28 (95% CI: 1.04–1.58) in men and 1.34 (95% CI: 1.08–1.65) in women. Among the subjects without microalbuminuria, the odds ratio of the highest versus lowest NEAP quartile for the presence of high normoalbuminuria was 1.21 (95% CI: 0.96–1.53) in men and 1.30 (95% CI: 1.04–1.63) in women.


NEAP score was associated with the presence of low-grade albuminuria in a Japanese adult population. Further studies are needed to confirm whether dietary acid load influences the development and progression of albuminuria.