Net Acid Excretion

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Thomas Remer - One of the best experts on this subject based on the ideXlab platform.

  • Inflammatory mediators in the adipo-renal axis: leptin, adiponectin, and soluble ICAM-1.
    American Journal of Physiology-Renal Physiology, 2020
    Co-Authors: Yifan Hua, Hermann Kalhoff, Jonas Esche, Danika Krupp, Christian Herder, Anette E. Buyken, Stefan A. Wudy, Thomas Remer
    Abstract:

    A lower 24-h urine pH (24h-pH), i.e., a higher renal Excretion of free protons, at a given Acid load to the body, denotes a reduction in the kidney’s capacity for Net Acid Excretion (NAE). There is...

  • Estimates of renal Net Acid Excretion and their relationships with serum uric Acid and hyperuricemia in a representative German population sample.
    European journal of clinical nutrition, 2020
    Co-Authors: Jonas Esche, Danika Krupp, Gert Bm Mensink, Thomas Remer
    Abstract:

    Preliminary interventional data suggest that a reduction of dietary Acid load raises renal uric Acid Excretion and decreases serum uric Acid (SUA). In line with this, in a recent cross-sectional analysis of a representative adult population sample, a higher potential renal Acid load (PRAL) was found to associate with higher SUA levels. Against this background, we re-examined the relationship of the body's Acid load with SUA and hyperuricemia using nutrition-derived estimates of renal Net Acid Excretion (NAE). Cross-sectional analyses were performed in n = 6894 participants (18-79 y) of the German Health Interview and Examination Survey for Adults (DEGS1). Two different approaches were used to estimate NAE, one based on the sum of food frequency questionnaire (FFQ)-derived PRAL and body-surface area-derived organic Acids (eNAEPRAL+OA) and the other based on FFQ-derived protein and potassium intake ratios (eNAEProt/K). The associations of eNAEPRAL+OA and eNAEProt/K with SUA were analyzed in multiple linear regression models. Multiple logistic regressions were used to calculate odds ratios (OR) for hyperuricemia comparing higher (T3) and lower (T1) tertiles of the NAE estimates. After adjusting for relevant confounders, eNAEPRAL+OA (p = 0.0048) and eNAEProt/K (p = 0.0023) were positively associated with SUA. In addition, participants with a higher eNAEPRAL+OA or eNAEProt/K had higher ORs for having hyperuricemia (OR: 1.73, 95% CI: 1.24-2.40, OR: 1.51, 95% CI: 1.10-2.08, respectively). The results substantiate findings of a previous analysis that dietary Acid load is a potential influencing factor on SUA. This implicates that a lower dietary Acid load may have beneficial effects on SUA.

  • prospective relation of adolescent citrate Excretion and Net Acid Excretion capacity with blood pressure in young adulthood
    American Journal of Physiology-renal Physiology, 2018
    Co-Authors: Danika Krupp, Jonas Esche, Timm H Westhoff, Thomas Remer
    Abstract:

    Experimental data and observational studies in adults suggest that even subtle changes in Acid-base balance, indicative of a higher systemic proton load, are related to higher blood pressure (BP) l...

  • longitudinal relationships between diet dependent renal Acid load and blood pressure development in healthy children
    Kidney International, 2014
    Co-Authors: Danika Krupp, Thomas Remer
    Abstract:

    Diets high in sulfur-rich protein and low in fruits and vegetables affect human Acid–base balance adversely. Corresponding subclinical forms of metabolic Acidosis have been linked to hypertension in adults. We longitudinally examined relations of dietary Acid load with blood pressure in 257 healthy prepuberty children with 3 or more parallel 3-day weighed dietary records, 24-h urine, and blood pressure measurements. Urinary Net Acid Excretion and the potential renal Acid load (PRAL), determined as the difference of major urinary nonbicarbonate anions and mineral cations, were used to predict dietary Acid load. PRAL was also calculated from dietary data. In repeated-measures regression analyses, adjusted for body size and dietary fiber, an intraindividual increase of 10mEq above the ‘usual' Net Acid Excretion or urine PRAL were each significantly related to a 0.6–0.7mmHg increased systolic blood pressure. Differences in urine PRAL among the children also significantly predicted between-person differences in systolic blood pressure. A higher individual Net Acid Excretion or urine PRAL and intraindividual increase in urine PRAL were significantly related to higher diastolic blood pressure. Blood pressure associations were nonsignificant for dietary PRAL and urinary sodium. Thus, in healthy children, renal biomarker analyses reveal an association of proton load with higher blood pressure. Especially for systolic blood pressure, a more alkalizing nutrition may be beneficial for blood pressure development within a given individual. Experimental confirmation of a causal Acid load–blood pressure link is required.

  • Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets
    European Journal of Clinical Nutrition, 2013
    Co-Authors: Lynda A Frassetto, Monique Schloetter, A. Sebastian, Thomas Remer
    Abstract:

    Background/objectives: Formulas developed to estimate diet-dependent Net Acid Excretion (NAE) generally agree with measured values for typical Western diets. Whether they can also appropriately predict NAE for ‘Paleolithic-type’ (Paleo) diets—which contain very high amounts of fruits and vegetables (F&V) and concurrent high amounts of protein is unknown. Here, we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D). Subjects/methods: Thirteen subjects with well-controlled T2D were randomized to either a Paleo or American Diabetes Association (ADA) diet for 14 days. Twenty-four hour urine collections were performed at baseline and end of the diet period, and analyzed for titratable Acid, bicarbonate and ammonium to calculate measured NAE. Three formulas for estimating NAE from dietary intake were used; two (NAE__diet R or L) that include dietary mineral intake and sulfate- and organic Acid (OA) production, and one that is empirically derived (NAE__diet F) only considering potassium and protein intake. Results: Measured NAE on the Paleo diet was significantly lower than on the ADA-diet (+31±22 vs 112±52 mEq/day, P =0.002). Although all formula estimates showed similar and reasonable correlations ( r =0.52–0.76) with measured NAE, each one underestimated measured values. The formula with the best correlation did not contain an estimate of dietary OA production. Conclusions: Paleo-diets are lower in NAE than typical Western diets. However, commonly used formulas clearly underestimate NAE, especially for diets with very high F&V (as the Paleo diet), and in subjects with T2D. This may be due to an inappropriate estimation of proton loads stemming from OAs, underlining the necessity for improved measures of OA-related proton sources.

I. David Weiner - One of the best experts on this subject based on the ideXlab platform.

Lynda A Frassetto - One of the best experts on this subject based on the ideXlab platform.

  • Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets
    European Journal of Clinical Nutrition, 2013
    Co-Authors: Lynda A Frassetto, Monique Schloetter, A. Sebastian, Thomas Remer
    Abstract:

    Background/objectives: Formulas developed to estimate diet-dependent Net Acid Excretion (NAE) generally agree with measured values for typical Western diets. Whether they can also appropriately predict NAE for ‘Paleolithic-type’ (Paleo) diets—which contain very high amounts of fruits and vegetables (F&V) and concurrent high amounts of protein is unknown. Here, we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D). Subjects/methods: Thirteen subjects with well-controlled T2D were randomized to either a Paleo or American Diabetes Association (ADA) diet for 14 days. Twenty-four hour urine collections were performed at baseline and end of the diet period, and analyzed for titratable Acid, bicarbonate and ammonium to calculate measured NAE. Three formulas for estimating NAE from dietary intake were used; two (NAE__diet R or L) that include dietary mineral intake and sulfate- and organic Acid (OA) production, and one that is empirically derived (NAE__diet F) only considering potassium and protein intake. Results: Measured NAE on the Paleo diet was significantly lower than on the ADA-diet (+31±22 vs 112±52 mEq/day, P =0.002). Although all formula estimates showed similar and reasonable correlations ( r =0.52–0.76) with measured NAE, each one underestimated measured values. The formula with the best correlation did not contain an estimate of dietary OA production. Conclusions: Paleo-diets are lower in NAE than typical Western diets. However, commonly used formulas clearly underestimate NAE, especially for diets with very high F&V (as the Paleo diet), and in subjects with T2D. This may be due to an inappropriate estimation of proton loads stemming from OAs, underlining the necessity for improved measures of OA-related proton sources.

  • Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets
    European Journal of Clinical Nutrition, 2013
    Co-Authors: Lynda A Frassetto, Monique Schloetter, A. Sebastian, Lijie Shi, Thomas Remer
    Abstract:

    Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets

  • renal Net Acid Excretion capacity is comparable in prepubescence adolescence and young adulthood but falls with aging
    Journal of the American Geriatrics Society, 2008
    Co-Authors: Shoma Berkemeyer, Lynda A Frassetto, Jürgen Vormann, Anke L. B. Günther, Ragnar Rylander, Thomas Remer
    Abstract:

    OBJECTIVES: To evaluate whether renal Net Acid Excretion capacity (NAEC) varies across different age groups and, specifically, whether it falls in elderly people. DESIGN: Cross-sectional observational study. SETTING: Community-based. PARTICIPANTS: Young participants were from the DOrtmund Nutritional and Anthropometric Longitudinally Designed Study, Dortmund, Germany; elderly participants were from Gothenburg, Sweden. MEASUREMENTS: Twenty-four-hour urine pH, Net Acid Excretion (NAE), urinary phosphorus, total nitrogen Excretion, and anthropometric data were measured in healthy elderly people (aged 55–75; n=85), young adults (aged 18–22; n=117), adolescents (aged 13–14; n=112), and prepubescent children (aged 6–7; n=217). NAEC was determined as 24-hour NAE adjusted for urine pH using the residual method. RESULTS: In elderly participants 24-hour urinary pH (5.9±0.53) was lower (P<.05) and NAE (60±27 mEq/d) higher (P<.05) than in the three other groups. In a regression model adjusted for age, sex, and body surface area, NAEC showed a clear decrease with age, with highest values in prepubescents and lowest in elderly participants. However, NAEC remained significantly lower only in elderly participants (P<.001) after the inclusion of total nitrogen Excretion, a protein intake index, which was included because protein intake is known to modulate renal function. NAEC was approximately 8 mEq/d lower in healthy elderly participants than in young adults. CONCLUSION: The capacity to excrete Net endogenous Acid does not vary markedly from childhood to young adulthood but falls significantly with age, implying that elderly people may require higher daily alkalizing mineral intake to compensate for renal function losses.

  • Renal Net Acid Excretion capacity is comparable in prepubescence, adolescence, and young adulthood but falls with aging.
    Journal of the American Geriatrics Society, 2008
    Co-Authors: Shoma Berkemeyer, Lynda A Frassetto, Jürgen Vormann, Anke L. B. Günther, Ragnar Rylander, Thomas Remer
    Abstract:

    OBJECTIVES: To evaluate whether renal Net Acid Excretion capacity (NAEC) varies across different age groups and, specifically, whether it falls in elderly people. DESIGN: Cross-sectional observational study. SETTING: Community-based. PARTICIPANTS: Young participants were from the DOrtmund Nutritional and Anthropometric Longitudinally Designed Study, Dortmund, Germany; elderly participants were from Gothenburg, Sweden. MEASUREMENTS: Twenty-four-hour urine pH, Net Acid Excretion (NAE), urinary phosphorus, total nitrogen Excretion, and anthropometric data were measured in healthy elderly people (aged 55–75; n=85), young adults (aged 18–22; n=117), adolescents (aged 13–14; n=112), and prepubescent children (aged 6–7; n=217). NAEC was determined as 24-hour NAE adjusted for urine pH using the residual method. RESULTS: In elderly participants 24-hour urinary pH (5.9±0.53) was lower (P

Jill W. Verlander - One of the best experts on this subject based on the ideXlab platform.

  • Differences in Acidosis-stimulated renal ammonia metabolism in the male and female kidney
    American Journal of Physiology-Renal Physiology, 2019
    Co-Authors: Autumn N. Harris, Jill W. Verlander, Hyun-wook Lee, Lijuan Fang, I. David Weiner
    Abstract:

    Renal ammonia Excretion is a critical component of Acid-base homeostasis, and changes in ammonia Excretion are the predominant component of increased Net Acid Excretion in response to metabolic aci...

  • Emerging Features of Ammonia Metabolism and Transport in Acid-Base Balance.
    Seminars in Nephrology, 2019
    Co-Authors: I. David Weiner, Jill W. Verlander
    Abstract:

    Ammonia metabolism has a critical role in Acid-base homeostasis and in other cellular functions. Kidneys have a central role in bicarbonate generation, which occurs through the process of Net Acid Excretion; ammonia metabolism is the quantitatively greatest component of Net Acid Excretion, both under basal conditions and in response to Acid-base disturbances. Several recent studies have advanced our understanding substantially of the molecular mechanisms and regulation of ammonia metabolism. First, the previous paradigm that ammonia transport could be explained by passive NH3 diffusion and NH4+ trapping has been advanced by the recognition that specific transport of NH3 and of NH4+ by specific membrane proteins is critical to ammonia transport. Second, significant advances have been made in the understanding of the regulation of ammonia metabolism. Novel studies have shown that hyperkalemia directly inhibits ammonia metabolism, thereby leading to the metabolic Acidosis present in type IV renal tubular Acidosis. Other studies have shown that the proximal tubule protein NBCe1, specifically the A variant NBCe1-A, has a major role in regulating renal ammonia metabolism. Third, there are important sex differences in ammonia metabolism that involve structural and functional differences in the kidney. This review addresses these important aspects of ammonia metabolism and transport.

  • Proximal tubule glutamine synthetase expression is necessary for the normal response to dietary protein restriction
    American Journal of Physiology-Renal Physiology, 2017
    Co-Authors: Hyun-wook Lee, Gunars Osis, Mary E. Handlogten, Jill W. Verlander, I. David Weiner
    Abstract:

    Dietary protein restriction has multiple benefits in kidney disease. Because protein intake is a major determinant of endogenous Acid production, it is important that Net Acid Excretion changes in ...

  • Ammonia Transporters and Their Role in Acid-Base Balance
    Physiological Reviews, 2017
    Co-Authors: I. David Weiner, Jill W. Verlander
    Abstract:

    Acid-base homeostasis is critical to maintenance of normal health. Renal ammonia Excretion is the quantitatively predominant component of renal Net Acid Excretion, both under basal conditions and i...

  • Effect of dietary protein restriction on renal ammonia metabolism.
    American Journal of Physiology-Renal Physiology, 2015
    Co-Authors: Hyun-wook Lee, Gunars Osis, Mary E. Handlogten, Jill W. Verlander, Hui Guo, I. David Weiner
    Abstract:

    Dietary protein restriction has multiple benefits in kidney disease. Because protein intake is a major determinant of endogenous Acid production, it is important that Net Acid Excretion change in p...

A. Sebastian - One of the best experts on this subject based on the ideXlab platform.

  • Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets
    European Journal of Clinical Nutrition, 2013
    Co-Authors: Lynda A Frassetto, Monique Schloetter, A. Sebastian, Thomas Remer
    Abstract:

    Background/objectives: Formulas developed to estimate diet-dependent Net Acid Excretion (NAE) generally agree with measured values for typical Western diets. Whether they can also appropriately predict NAE for ‘Paleolithic-type’ (Paleo) diets—which contain very high amounts of fruits and vegetables (F&V) and concurrent high amounts of protein is unknown. Here, we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D). Subjects/methods: Thirteen subjects with well-controlled T2D were randomized to either a Paleo or American Diabetes Association (ADA) diet for 14 days. Twenty-four hour urine collections were performed at baseline and end of the diet period, and analyzed for titratable Acid, bicarbonate and ammonium to calculate measured NAE. Three formulas for estimating NAE from dietary intake were used; two (NAE__diet R or L) that include dietary mineral intake and sulfate- and organic Acid (OA) production, and one that is empirically derived (NAE__diet F) only considering potassium and protein intake. Results: Measured NAE on the Paleo diet was significantly lower than on the ADA-diet (+31±22 vs 112±52 mEq/day, P =0.002). Although all formula estimates showed similar and reasonable correlations ( r =0.52–0.76) with measured NAE, each one underestimated measured values. The formula with the best correlation did not contain an estimate of dietary OA production. Conclusions: Paleo-diets are lower in NAE than typical Western diets. However, commonly used formulas clearly underestimate NAE, especially for diets with very high F&V (as the Paleo diet), and in subjects with T2D. This may be due to an inappropriate estimation of proton loads stemming from OAs, underlining the necessity for improved measures of OA-related proton sources.

  • Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets
    European Journal of Clinical Nutrition, 2013
    Co-Authors: Lynda A Frassetto, Monique Schloetter, A. Sebastian, Lijie Shi, Thomas Remer
    Abstract:

    Established dietary estimates of Net Acid production do not predict measured Net Acid Excretion in patients with Type 2 diabetes on Paleolithic–Hunter–Gatherer-type diets

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