Kidney Week

Abstract: SA-PO1053

Dietary Acid Load and the Risk of Metabolic Acidosis in Prevalent Hemodialysis Patients

Session Information

• Diet and Nutrition: Clinical
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Lee, Mi Jung, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)

Mi Jung Lee,

• Kim, Hyung Jong, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)

Hyung Jong Kim,

• Park, Jung Tak, Yonsei University Health System, Seodaemun-Gu, Seoul, Korea (the Republic of)

Jung Tak Park,

• Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)

Jung Pyo Lee,

• Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yon Su Kim,

• Kim, Yong-Lim, Kyungpook National University Hospital, Daegu, Korea (the Republic of)

Yong-Lim Kim,

• Ryu, Dong-Ryeol, Ewha Womans University, Seoul, Korea (the Republic of)

Dong-Ryeol Ryu,

Background

Metabolic acidosis is associated with protein energy wasting, bone disease, and higher mortality in end-stage renal disease (ESRD). Although higher dietary acid load can exacerbate metabolic acidosis, there is a lack of data evaluating their relationship in ESRD patients. Therefore, we investigated the association between dietary acid load and metabolic acidosis in ESRD patients undergoing hemodialysis (HD).

Methods

One hundred and eleven prevalent HD patients were included from the ESRD-Clinical Research Center (ESRD-CRC) cohort in South Korea. Dietary intake data were obtained from a self-reported food frequency questionnaire and a 7-day food diary. Dietary acid load was estimated using the equation for potential renal acid load (PRAL). Metabolic acidosis was defined as serum bicarbonate <22 mEq/L.

Results

The median value of PRAL was 9.97 (interquartile range, 4.45-14.06) mEq/day. Metabolic acidosis was observed in 47 patients (42.3%). The independent association of PRAL with metabolic acidosis was analyzed by binary logistic regression analysis. Multivariable analysis indicated that higher PRAL was significantly associated with risk of metabolic acidosis after adjusting confounding factors (per 1 standard deviation increase, odds ratio=3.258, 95% confidence interval [CI]=1.106-9.599, P=0.03). Subsequent linear regression analysis was performed to find dietary behavior factors affecting PRAL. Higher intake of processed meat including ham, sausage, or bacon, was significantly associated with increased PRAL (per 1 intake/week increase, β=0.244, 95% CI for B=0.704-9.164, P=0.02).

Conclusion

PRAL was the independent risk factor for metabolic acidosis in prevalent HD patients, suggesting deleterious effect of higher dietary acid load. Therefore, dietary counseling or intervention to reduce processed meat intake may be helpful for management of metabolic acidosis in these patients.