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

Identifier:  imarina:9283411

Handle: https://hdl.handle.net/20.500.11797/imarina9283411

Authors:  Valle-Hita, Cristina; Becerra-Tomas, Nerea; Diaz-Lopez, Andres; Vazquez-Ruiz, Zenaida; Megias, Isabel; Corella, Dolores; Goday, Albert; Alfredo Martinez, J; Alonso-Gomez, Angel M; Warnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Serra-Majem, Lluis; Bueno-Cavanillas, Aurora; Tur, Josep A; Martin-Sanchez, Vicente; Pinto, Xavier; Gaforio, Jose J; Matia-Martin, Pilar; Vidal, Josep; Amengual-Galbarte, Angela; Daimiel, Lidia; Ros, Emilio; Garcia-Arellano, Ana; Barragan, Rocio; Fito, Montse; Pena-Orihuela, Patricia J; Asencio-Aznar, Alberto; Gomez-Gracia, Enrique; Martinez-Urbistondo, Diego; Morey, Marga; Casas, Rosa; Maria Garrido-Garrido, Eva; Tojal-Sierra, Lucas; Damas-Fuentes, Miguel; Goni, Estibaliz; Ortega-Azorin, Carolina; Castaner, Olga; Garcia-Rios, Antonio; Gisbert-Selles, Cristina; Sayon-Orea, Carmen; Schroder, Helmut; Salas-Salvado, Jordi; Babio, Nancy

Abstract:
Background: Diets 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). Methods: Older 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. Results: After 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. Conclusions: Higher 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.