Assessment of dietary acid burden in adult patients with end-stage renal disease undergoing dialysis: a pilot study

Introduction
Literature data clearly indicate that consumption of an acid-forming diet by renal failure patients on dialysis can worsen acid-base balance parameters by lowering serum bicarbonate levels. Conversely, consumption of an alkaline-forming diet while controlling potassium and phosphorus intake may be helpful in maintaining predialysis bicarbonate levels within reference values.

Aim of the research
Evaluate the nutritional value of daily rations of patients with renal failure treated with dialysis in terms of balancing the intake of acid- and alkaline-forming components.

Material and methods
Fifty-four patients (35 men, 19 women) with end-stage renal failure undergoing dialysis therapy were enrolled in the study. A dietary history of 3 non-dialysis days of the week was collected from the subjects. Nutrient intake was assessed using Aliant software (Anmarsoft).

Results
The results of the in-house analysis showed that as many as 48 of the 54 participating patients (88.9%) consumed an acid-forming diet. It was observed that the unfavourable nature of the rations of the studied patients was mainly influenced by the low intake of alkaline-forming components, such as calcium and magnesium, and in the group of men also by a higher-than-recommended intake of phosphorus. The median PRAL index (potential renal acid load) of the analysed rations was 9.49 and was significantly higher in males.

Conclusions
Observations made in the study, related to the improper dietary balance of dialysis patients, indicate the need to intensify nutrition education as an element in the routine care of dialysis patients in order to increase the effectiveness of patients’ adherence to an alkaline-forming diet.