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Nutrients 2018, 10(4), 512;

Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease

University Stone Centre, Department of Urology, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
Received: 27 March 2018 / Revised: 14 April 2018 / Accepted: 17 April 2018 / Published: 20 April 2018
(This article belongs to the Special Issue Nutritional Prevention and Acid Base Status)
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Chronic kidney disease and reduced glomerular filtration rate are risk factors for the development of chronic metabolic acidosis. The prevention or correction of chronic metabolic acidosis has been found to slow progression of chronic kidney disease. Dietary composition can strongly affect acid–base balance. Major determinants of net endogenous acid production are the generation of large amounts of hydrogen ions, mostly by animal-derived protein, which is counterbalanced by the metabolism of base-producing foods like fruits and vegetables. Alkali therapy of chronic metabolic acidosis can be achieved by providing an alkali-rich diet or oral administration of alkali salts. The primary goal of dietary treatment should be to increase the proportion of fruits and vegetables and to reduce the daily protein intake to 0.8–1.0 g per kg body weight. Diet modifications should begin early, i.e., even in patients with moderate kidney impairment, because usual dietary habits of many developed societies contribute an increased proportion of acid equivalents due to the high intake of protein from animal sources. View Full-Text
Keywords: metabolic acidosis; kidney disease; urolithiasis; urinary stones; protein; fruits; vegetables; bicarbonate; alkali citrate metabolic acidosis; kidney disease; urolithiasis; urinary stones; protein; fruits; vegetables; bicarbonate; alkali citrate

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Siener, R. Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease. Nutrients 2018, 10, 512.

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