The Role of Dietary Acid Load on Progression of Estimated Glomerular Filtration Rate Among Individuals Diagnosed With Chronic Kidney Disease

J Ren Nutr. 2024 Mar 14:S1051-2276(24)00037-2. doi: 10.1053/j.jrn.2024.03.001. Online ahead of print.


Objective: Individuals with chronic kidney disease (CKD) are at an increased risk for developing metabolic acidosis. Metabolic acidosis has been shown to worsen kidney function and exacerbate systemic inflammation. Diets high in protein foods can exacerbate metabolic acidosis as protein foods tend to be more acidic, while fruits and vegetables are more alkalotic. The main objective of this systematic review was to determine if higher consumption of fruits and vegetables in adults with CKD stages 1-5 reduces the rate of decline of estimated glomerular filtration rate.

Methods: Searches of Cumulated Index to Nursing and Allied Health Literature (CINAHL -Elton B. Stephens Company [EBSCO]), Cochrane Library (Wiley), Dissertation & Thesis Global (ProQuest), Embase (Elsevier), Medline (OVID), PubMed (National Library of Medicine), Scopus (Elsevier), and Web of Sciences (Clarivate) identified 1,451 articles published between January 2015 and June 2023.

Results: After independent review, 7 total studies were included. Six of the studies found an association between dietary acid load and progression of CKD.

Conclusions: Dietary counseling focusing on decreasing dietary acid load may be beneficial for individuals with CKD.

Keywords: Kidney disease; chronic kidney disease; dietary acid load; eGFR; inflammation; kidney function; renal disease; vegan; vegetarian.

Publication types

  • Review