Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus

ObjectiveThis study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).DesignA total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed us...

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Main Authors: Hui Huang, Qian Wang, Ruimin Zhang, Fang Liu, Yue Niu, Yayong Luo, Shuang Li, Tao Li, Zhengchun Tang, Xiaolong Wang, Jian Yang, Yong Wang, Li Zhang, Sha Luo, Weiguang Zhang, Ying Zheng, Weizhu Deng, Guangyan Cai, Xiangmei Chen, Zheyi Dong
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1581009/full
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author Hui Huang
Hui Huang
Qian Wang
Ruimin Zhang
Ruimin Zhang
Fang Liu
Fang Liu
Yue Niu
Yayong Luo
Shuang Li
Tao Li
Zhengchun Tang
Zhengchun Tang
Xiaolong Wang
Jian Yang
Yong Wang
Li Zhang
Sha Luo
Weiguang Zhang
Ying Zheng
Weizhu Deng
Guangyan Cai
Xiangmei Chen
Xiangmei Chen
Xiangmei Chen
Zheyi Dong
author_facet Hui Huang
Hui Huang
Qian Wang
Ruimin Zhang
Ruimin Zhang
Fang Liu
Fang Liu
Yue Niu
Yayong Luo
Shuang Li
Tao Li
Zhengchun Tang
Zhengchun Tang
Xiaolong Wang
Jian Yang
Yong Wang
Li Zhang
Sha Luo
Weiguang Zhang
Ying Zheng
Weizhu Deng
Guangyan Cai
Xiangmei Chen
Xiangmei Chen
Xiangmei Chen
Zheyi Dong
author_sort Hui Huang
collection DOAJ
description ObjectiveThis study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).DesignA total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed using a 24-h dietary recall, and diet-based acidity was assessed using net endogenous acid production (NEAP), potential renal acid load (PRAL), and dietary acid load (DAL). Multivariable logistic regression models were used to determine the association between diet-based acid load scores and CKD and T2DM.ResultsWithin the food category groupings, the DAL score was positively associated with poultry and eggs and negatively associated with fruits and vegetables. Regarding energy and macronutrients, the DAL score was positively correlated with the intake of protein, animal protein, monounsaturated fatty acids, saturated fatty acids, and fat, while it was negatively correlated with the intake of carbohydrates, plant protein, and dietary fiber. In terms of micronutrients, DAL scores were positively associated with phosphorus intake and negatively associated with potassium, magnesium, and copper intake. After adjusting for age, BMI, energy, and eGFR, and stratifying by sex, logistic regression analysis showed that DAL level (OR = 6.47, 95% CI 1.19–35.18, p = 0.031) was a related factor for CKD and T2DM in females.ConclusionDAL score is a related factor for patients with T2DM and CKD.
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spelling doaj-art-2ee7015d98bb4e409446c709dfb340f92025-08-20T02:25:44ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-05-011210.3389/fnut.2025.15810091581009Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitusHui Huang0Hui Huang1Qian Wang2Ruimin Zhang3Ruimin Zhang4Fang Liu5Fang Liu6Yue Niu7Yayong Luo8Shuang Li9Tao Li10Zhengchun Tang11Zhengchun Tang12Xiaolong Wang13Jian Yang14Yong Wang15Li Zhang16Sha Luo17Weiguang Zhang18Ying Zheng19Weizhu Deng20Guangyan Cai21Xiangmei Chen22Xiangmei Chen23Xiangmei Chen24Zheyi Dong25Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaChengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaSchool of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaHenan University of Traditional Chinese Medicine, Zhengzhou, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaSchool of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaChengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaSchool of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, ChinaState Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, ChinaObjectiveThis study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).DesignA total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed using a 24-h dietary recall, and diet-based acidity was assessed using net endogenous acid production (NEAP), potential renal acid load (PRAL), and dietary acid load (DAL). Multivariable logistic regression models were used to determine the association between diet-based acid load scores and CKD and T2DM.ResultsWithin the food category groupings, the DAL score was positively associated with poultry and eggs and negatively associated with fruits and vegetables. Regarding energy and macronutrients, the DAL score was positively correlated with the intake of protein, animal protein, monounsaturated fatty acids, saturated fatty acids, and fat, while it was negatively correlated with the intake of carbohydrates, plant protein, and dietary fiber. In terms of micronutrients, DAL scores were positively associated with phosphorus intake and negatively associated with potassium, magnesium, and copper intake. After adjusting for age, BMI, energy, and eGFR, and stratifying by sex, logistic regression analysis showed that DAL level (OR = 6.47, 95% CI 1.19–35.18, p = 0.031) was a related factor for CKD and T2DM in females.ConclusionDAL score is a related factor for patients with T2DM and CKD.https://www.frontiersin.org/articles/10.3389/fnut.2025.1581009/fullchronic kidney diseasetype 2 diabetes mellitusdietary acid loadpotential renal acid loadnet endogenous acid
spellingShingle Hui Huang
Hui Huang
Qian Wang
Ruimin Zhang
Ruimin Zhang
Fang Liu
Fang Liu
Yue Niu
Yayong Luo
Shuang Li
Tao Li
Zhengchun Tang
Zhengchun Tang
Xiaolong Wang
Jian Yang
Yong Wang
Li Zhang
Sha Luo
Weiguang Zhang
Ying Zheng
Weizhu Deng
Guangyan Cai
Xiangmei Chen
Xiangmei Chen
Xiangmei Chen
Zheyi Dong
Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
Frontiers in Nutrition
chronic kidney disease
type 2 diabetes mellitus
dietary acid load
potential renal acid load
net endogenous acid
title Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
title_full Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
title_fullStr Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
title_full_unstemmed Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
title_short Correlation between dietary acid–base load and chronic kidney disease patients with type 2 diabetes mellitus
title_sort correlation between dietary acid base load and chronic kidney disease patients with type 2 diabetes mellitus
topic chronic kidney disease
type 2 diabetes mellitus
dietary acid load
potential renal acid load
net endogenous acid
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1581009/full
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