Frontiers in Nutrition (Sep 2022)

Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

  • Cristina Valle-Hita,
  • Cristina Valle-Hita,
  • Cristina Valle-Hita,
  • Nerea Becerra-Tomás,
  • Nerea Becerra-Tomás,
  • Andrés Díaz-López,
  • Andrés Díaz-López,
  • Andrés Díaz-López,
  • Andrés Díaz-López,
  • Zenaida Vázquez-Ruiz,
  • Zenaida Vázquez-Ruiz,
  • Isabel Megías,
  • Dolores Corella,
  • Dolores Corella,
  • Albert Goday,
  • Albert Goday,
  • J. Alfredo Martínez,
  • J. Alfredo Martínez,
  • J. Alfredo Martínez,
  • Ángel M. Alonso-Gómez,
  • Ángel M. Alonso-Gómez,
  • Julia Wärnberg,
  • Julia Wärnberg,
  • Jesús Vioque,
  • Jesús Vioque,
  • Dora Romaguera,
  • Dora Romaguera,
  • José López-Miranda,
  • José López-Miranda,
  • Ramon Estruch,
  • Ramon Estruch,
  • Francisco J. Tinahones,
  • Francisco J. Tinahones,
  • José Lapetra,
  • José Lapetra,
  • Lluís Serra-Majem,
  • Lluís Serra-Majem,
  • Aurora Bueno-Cavanillas,
  • Aurora Bueno-Cavanillas,
  • Josep A. Tur,
  • Josep A. Tur,
  • Josep A. Tur,
  • Vicente Martín-Sánchez,
  • Vicente Martín-Sánchez,
  • Xavier Pintó,
  • Xavier Pintó,
  • Xavier Pintó,
  • José J. Gaforio,
  • José J. Gaforio,
  • Pilar Matía-Martín,
  • Josep Vidal,
  • Josep Vidal,
  • Angela Amengual-Galbarte,
  • Lidia Daimiel,
  • Emilio Ros,
  • Emilio Ros,
  • Ana García-Arellano,
  • Ana García-Arellano,
  • Ana García-Arellano,
  • Rocío Barragán,
  • Rocío Barragán,
  • Montse Fitó,
  • Montse Fitó,
  • Patricia J. Peña-Orihuela,
  • Patricia J. Peña-Orihuela,
  • Alberto Asencio-Aznar,
  • Enrique Gómez-Gracia,
  • Enrique Gómez-Gracia,
  • Diego Martinez-Urbistondo,
  • Marga Morey,
  • Marga Morey,
  • Rosa Casas,
  • Rosa Casas,
  • Eva María Garrido-Garrido,
  • Lucas Tojal-Sierra,
  • Lucas Tojal-Sierra,
  • Miguel Damas-Fuentes,
  • Miguel Damas-Fuentes,
  • Estibaliz Goñi,
  • Carolina Ortega-Azorín,
  • Carolina Ortega-Azorín,
  • Olga Castañer,
  • Olga Castañer,
  • Antonio Garcia-Rios,
  • Antonio Garcia-Rios,
  • Cristina Gisbert-Sellés,
  • Carmen Sayón-Orea,
  • Carmen Sayón-Orea,
  • Helmut Schröder,
  • Helmut Schröder,
  • Jordi Salas-Salvadó,
  • Jordi Salas-Salvadó,
  • Jordi Salas-Salvadó,
  • Nancy Babio,
  • Nancy Babio,
  • Nancy Babio

DOI
https://doi.org/10.3389/fnut.2022.986190
Journal volume & issue
Vol. 9

Abstract

Read online

BackgroundDiets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (UACR).MethodsOlder adults with overweight/obesity and metabolic syndrome (mean age 65 ± 5 years, 48% women) from the PREDIMED-Plus study who had available data on eGFR (n = 5,874) or UACR (n = 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline from a food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year-changes in eGFR and UACR were set as the primary outcomes. We secondarily assessed ≥ 10% eGFR decline or ≥10% UACR increase.ResultsAfter multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, β: –0.64 ml/min/1.73 m2; 95% CI: –1.21 to –0.08 and NEAP, β: –0.56 ml/min/1.73 m2; 95% CI: –1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing ≥10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07–1.54 and NEAP, OR: 1.24; 95% CI: 1.03–1.50) and ≥10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04–1.46) compared to individuals with lower dietary acid load.ConclusionsHigher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity and metabolic syndrome.

Keywords