ReviewAdvances in chronic kidney disease2013
Dietary acid load: a novel nutritional target in chronic kidney disease?
Review in Advances in chronic kidney disease, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
121 citing papers in PubMed, 7 syntheses or guidelines pooled it, 244 citations in OpenAlex.
- Effects of dietary interventions for metabolic acidosis in chronic kidney disease: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Pooled it
- Pharmacological Nephroprotection in Chronic Kidney Disease Patients with Type 2 Diabetes Mellitus-Clinical Practice Position Statement of the Polish Society of Nephrology.International journal of molecular sciences · 2024Guideline
- Association of High Dietary Acid Load With the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies.Frontiers in nutrition · 2022Pooled it
- The Relationship between Modern Fad Diets and Kidney Stone Disease: A Systematic Review of Literature.Nutrients · 2021Pooled it
- Dietary Potassium Intake and Risk of Chronic Kidney Disease Progression in Predialysis Patients with Chronic Kidney Disease: A Systematic Review.Advances in nutrition (Bethesda, Md.) · 2020Pooled it
- Dietary Patterns and Renal Health Outcomes in the General Population: A Review Focusing on Prospective Studies.Nutrients · 2019Pooled it
- Animal versus plant protein and adult bone health: A systematic review and meta-analysis from the National Osteoporosis Foundation.PloS one · 2018Pooled it
- The effect of a low renal acid load diet on blood pressure, lipid profile, and blood glucose indices in patients with type 2 diabetes: a randomized clinical trial.Nutrition journal · 2023Trial
- A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals.International journal of environmental research and public health · 2021Trial
- Effect of Bicarbonate on Net Acid Excretion, Blood Pressure, and Metabolism in Patients With and Without CKD: The Acid Base Compensation in CKD Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021Trial
- Correction of metabolic acidosis improves insulin resistance in chronic kidney disease.BMC nephrology · 2016Trial
- Reply to Song et al.: "Comment on prospective associations between the CKD-mineral bone disorder and metabolic acidosis".International urology and nephrology · 2026Article
- Comment on "Prospective associations between the CKD-mineral bone disorder and metabolic acidosis".International urology and nephrology · 2026Article
- Localized Intratumoral Ammonium Hydroxide Administration Demonstrates Changes in Tumor Architecture and Renal Response in a Murine Breast Cancer Xenograft Model.Current issues in molecular biology · 2026Article
- Trajectories of Serum Total Carbon Dioxide and the Risk of Cardiorenal Outcomes in Chronic Kidney Disease: Results From the KNOW-CKD Study.Kidney medicine · 2026Article
- The association between dietary acid load and endometriosis: a case-control study.BMC women's health · 2026Article
- Dietary Acid Load, Empirical Dietary Inflammatory Index, and Literature-Based Adherence to Mediterranean Diet Score Relationship With Primary Dysmenorrhea.Food science & nutrition · 2026Article
- DASH diet, Reduced Rank Regression Dietary Patterns and relations with kidney function in the CHRIS general population study.BMC nephrology · 2026Article
- Proteomic Markers of Dietary Patterns, CKD Progression, and Mortality in the CRIC Study.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Adjusting Autonomic Physiology with Diet and Minerals to Improve Health.Integrative medicine (Encinitas, Calif.) · 2026Review
61 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
Nonvolatile acid is produced from the metabolism of organic sulfur in dietary protein and the production of organic anions during the combustion of neutral foods. Organic anion salts that are found primarily in plant foods are directly absorbed in the gastrointestinal tract and yield bicarbonate. The difference between endogenously produced nonvolatile acid and absorbed alkali precursors yields the dietary acid load, technically known as the net endogenous acid production, and must be excreted by the kidney to maintain acid-base balance. Although typically 1 mEq/kg/day, dietary acid load is lower with greater intake of fruits and vegetables. In the setting of CKD, a high dietary acid load invokes adaptive mechanisms to increase acid excretion despite reduced nephron number, such as increased per nephron ammoniagenesis and augmented distal acid excretion mediated by the renin-angiotensin system and endothelin-1. These adaptations may promote kidney injury. Additionally, high dietary acid loads produce low-grade, subclinical acidosis that may result in bone and muscle loss. Early studies suggest that lowering the dietary acid load can improve subclinical acidosis, preserve bone and muscle, and slow the decline of glomerular filtration rate in animal models and humans. Studies focusing on hard clinical outcomes are needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.