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Abstract: SA-PO1053

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

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical


  • Lee, Mi Jung, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)
  • Kim, Hyung Jong, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)
  • Park, Jung Tak, Yonsei University Health System, Seodaemun-Gu, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yong-Lim, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Ryu, Dong-Ryeol, Ewha Womans University, Seoul, Korea (the Republic of)

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).


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.


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).


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.