Alkaline Diet and Metabolic Acidosis: Practical Approaches to the Nutritional Management of Chronic Kidney Disease

Angéloco, Larissa Rodrigues Neto; Souza, Gabriela Cristina Arces de; Romão, Elen Almeida; Chiarello, Paula Garcia

doi:10.1053/j.jrn.2017.10.006

Cited by 32 publications

(26 citation statements)

References 47 publications

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“…The favorable impact on the gut microbiome [ 70 ] similarly leads to lower levels of other uremic toxins such as indoxyl sulfate and p-cresol sulfate [ 71 ]. Decreased acid load: plant foods have a lower acidogenicity in contrast to animal foods, and this alkalization may have additional effects beyond mere intake of natural alkali [ 72 ]. Reduced phosphorus burden: there is less absorbable phosphorus in plant-based proteins given the presence of indigestible phytate binding to plant-based phosphorus.…”

Section: Benefits Of a Plant-dominant Low Protein Dietmentioning

confidence: 99%

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Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

et al. 2020

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Chronic kidney disease (CKD) affects >10% of the adult population. Each year, approximately 120,000 Americans develop end-stage kidney disease and initiate dialysis, which is costly and associated with functional impairments, worse health-related quality of life, and high early-mortality rates, exceeding 20% in the first year. Recent declarations by the World Kidney Day and the U.S. Government Executive Order seek to implement strategies that reduce the burden of kidney failure by slowing CKD progression and controlling uremia without dialysis. Pragmatic dietary interventions may have a role in improving CKD outcomes and preventing or delaying dialysis initiation. Evidence suggests that a patient-centered plant-dominant low-protein diet (PLADO) of 0.6–0.8 g/kg/day composed of >50% plant-based sources, administered by dietitians trained in non-dialysis CKD care, is promising and consistent with the precision nutrition. The scientific premise of the PLADO stems from the observations that high protein diets with high meat intake not only result in higher cardiovascular disease risk but also higher CKD incidence and faster CKD progression due to increased intraglomerular pressure and glomerular hyperfiltration. Meat intake increases production of nitrogenous end-products, worsens uremia, and may increase the risk of constipation with resulting hyperkalemia from the typical low fiber intake. A plant-dominant, fiber-rich, low-protein diet may lead to favorable alterations in the gut microbiome, which can modulate uremic toxin generation and slow CKD progression, along with reducing cardiovascular risk. PLADO is a heart-healthy, safe, flexible, and feasible diet that could be the centerpiece of a conservative and preservative CKD-management strategy that challenges the prevailing dialysis-centered paradigm.

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Section: Benefits Of a Plant-dominant Low Protein Dietmentioning

confidence: 99%

“…Decreased acid load: plant foods have a lower acidogenicity in contrast to animal foods, and this alkalization may have additional effects beyond mere intake of natural alkali [ 72 ].…”

Section: Benefits Of a Plant-dominant Low Protein Dietmentioning

confidence: 99%

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

et al. 2020

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“…It is well stablished in the literature that a high protein intake may harm renal function in a CKD scenario, what has been studied in the past years is what is the source of protein that may in fact develop and promote the deterioration of renal function (Rodrigues Neto Angéloco et al, 2018). The last studies show that the reduced consumption of fruits and vegetables increases endogenous formation of acids and may intensify the worsening of disease-related complications in these patients (Toba et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Dietary acid load in a group of kidney transplantation candidates

Medeiros

Sales

Sousa

et al. 2021

RSD

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Objective: The objective of the study was to estimate and analyze the Potential Renal Acid Load (PRAL) of the diet in patients maintenance hemodialysis who are candidates for transplantation. Methodology: A cross-sectional study was conducted. The sample was separated in terciles of the PRAL. For the association between the PRAL and the independent variables, non-adjusted multinomial logistic regression and adjusted by potential confounders were implemented. It was assumed a p< 0,05 for statistical significance. Results: It was noticed that protein (g), the protein /kg of weight (g/kg), % of animal and vegetal protein, the phosphorus (mg), the lipid (g), and the carbohydrate (g) showed differences between the terciles (p<0,05). In regression, the greatest consumption of protein (g), protein g/kg of weight (g/kg), % of animal protein and lipid (g) was associated with the tercile 3 to tercile 1, whereas the greatest consumption of carbohydrate and % vegetal protein showed a protective effect. Conclusion: The results show an association between the PRAL and the protein consumption with the difference between the sources. It was not found an association between PRAL and the variables of nutritional status.

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“…A vegan dietary pattern high in fruits and vegetables favors alkalization, which improves the metabolic parameters of acidosis, preserving bone and muscle, and slowing the glomerular filtration rate decline. 43 There are potentially favorable impacts of a vegetarian diet on minerals, such as phosphorus, potassium, and sodium control. Minerals, increasingly being used as food additives in processed, frozen, or packaged foods, were shown to contribute to dietary phosphorus and potassium loads in patients with CKD.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

A Narrative Review of Dietary Approaches for Kidney Transplant Patients

Cyrino

Galpern

Moore

et al. 2021

Kidney International Reports

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Alkaline Diet and Metabolic Acidosis: Practical Approaches to the Nutritional Management of Chronic Kidney Disease

Cited by 32 publications

References 47 publications

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

Dietary acid load in a group of kidney transplantation candidates

A Narrative Review of Dietary Approaches for Kidney Transplant Patients

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