Abstract: FR-PO1152
Association of Albuminuria with Higher Dietary Acid Production and Lower Household Income in Patients with Hypertension-Associated CKD
Session Information
- CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Goraya, Nimrit, Baylor Scott and White Central Texas, Temple, Texas, United States
- Simoni, Jan, Texas Tech University System, Lubbock, Texas, United States
- Xie, Luyu, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Wu, Michael, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Wesson, Donald E., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background
Urine albumin (mg)-to-creatinine (g) ratio (UACR) >30 mg/g indicates chronic kidney disease (CKD), and higher UACR is associated with greater risk for eGFR decline. Higher dietary potential renal acid load (PRAL) is associated with greater CKD incidence and faster eGFR decline. Lower fruit and vegetable (F&V) intake mediates higher PRAL. Because dietary F&Vs are comparably expensive, we tested the hypothesis that higher UACR is associated with higher PRAL and with lower household income.
Methods
In a 1:1 matched case-control study, 153 non-diabetic study participants with primary hypertension and macroalbuminuria (UACR >200 mg/g) and normal eGFR (>90 ml/min/1.73 m2) were matched by age, sex, systolic blood pressure, and eGFR with 153 participants with normoalbuminuria (UACR <20 mg/g) through a feature that flagged clinic patients with a hypertension diagnosis for UACR measurement. Multivariable linear regression with least square means was used to examine the association between UACR and PRAL.
Results
Comparing macroalbuminuria with normoalbuminuria participants, least squares means for PRAL was higher (56.6 mmol/day [95% CI: 55.8 – 57.5] vs. 52.5 mmol/day [95% CI 51.6 – 53.3], respectively) and for F&V intake was lower (1.66 cups/day [95% CI 1.57 – 1.74] vs. 2.24 cups/day [95% CI 2.15 – 2.33]). After adjusting for key covariates, higher UACR was significantly associated with higher PRAL (β = 5.25, SE = 1.23, p <0.0001) and lower F&V intake was significantly associated with higher PRAL (β= -18.45, SE = 0.41, p <0.0001). Regarding potential association with household income, PRAL was negatively correlated (coefficient = -0.87, p <0.0001) but F&V intake was positively correlated (coefficient = 0.85, p <0.0001). Higher UACR was significantly associated with lower monthly income (β= -0.25, SE = 0.02, p <0.0001). None of the described associations were significantly influenced by Black, White, or Hispanic ethnicity (p >0.05).
Conclusion
The data support that higher PRAL due to lower F&V intake in patients with primary hypertension mediates their albuminuria risk . The association of lower F&V intake with lower household income might contribute to the greater risk for, and faster progression of, CKD in individuals from under-resourced communities.