Dietary Acid Load: mechanisms and evidence of its health repercussions

Nefrologia (Engl Ed). 2019 Jul-Aug;39(4):343-354. doi: 10.1016/j.nefro.2018.10.005. Epub 2019 Feb 5.
[Article in English, Spanish]


Diet composition has long been known to influence acid-base balance by providing acid or base precursors. In general, foods rich in protein, such as meat, cheese, eggs, and others, increase the production of acid in the body, whereas fruit and vegetables increase alkalis. The capacity of acid or base production of any food is called potential renal acid load (PRAL). Diets high in PRAL induce a low-grade metabolic acidosis state, which is associated with the development of metabolic alterations such as insulin resistance, diabetes, hypertension, chronic kidney disease, bone disorders, low muscle mass and other complications. The aim of this paper is to review the available evidence which evaluates the association of the PRAL of the diet with the incidence of chronic diseases and metabolic disorders, as well as related mechanisms involved in their development.

Keywords: Acidosis metabólica; Carga ácida potencial renal; Intervención nutricional; Metabolic acidosis; Net endogenous acid production; Nutritional intervention; Potential renal acid load; Producción neta de ácido; Proteins; Proteínas.

Publication types

  • Review

MeSH terms

  • Acid-Base Equilibrium*
  • Diet* / adverse effects
  • Humans
  • Kidney / metabolism*