Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 426010
Title Dietary acid load and rapid progression to end-stage renal disease of diabetic nephropathy in Westernized South Asian people
Author(s) Berg, E. van den; Hospers, F.A.P.; Navis, G.; Engberink, M.F.; Brink, E.J.; Geleijnse, J.M.; Baak, M.A. van; Gans, R.O.B.; Bakker, S.J.L.
Source Journal of Nephrology 24 (2011)1. - ISSN 1121-8428 - p. 11 - 17.
Department(s) Chair Nutrition and Health over the Lifecourse
Chair Nutrition and Disease
Publication type Refereed Article in a scientific journal
Publication year 2011
Keyword(s) chronic kidney-disease - contrast-induced nephropathy - population-based assessment - tubular epithelial-cells - sodium-bicarbonate - united-states - complement activation - african-americans - n-acetylcysteine - controlled-trial
Abstract Diabetic nephropathy is now the most common cause of end-stage renal failure in many countries of the world. Despite increasing implementation of preventive treatment, the chance that an individual diabetic patient will reach end-stage renal failure has been increasing rather than decreasing during recent decades. Current dietary habits in The Netherlands and the rest of the Western world are slowly shifting from relatively alkalinizing (e.g., potatoes and vegetables) toward more acidifying (e.g., rice and meat). Moreover, immigrants who consumed traditional diets in their homelands, usually adapt to Western dietary habits. This phenomenon of diet acculturation could, for instance, be involved in the up to 40 times higher chance of development of end-stage renal failure in association with diabetes in South-Asian immigrants compared with whites, in Western countries. High ingestion of nonvolatile acids with food increases susceptibility for progression to end-stage renal failure. These high dietary acid loads lead to compensatory increases in renal acid excretion and ammoniagenesis. The price paid for maintenance of acid-base homeostasis is renal tubulointerstitial injury, with subsequent decline in renal function and induction of hypertension. The tendency for metabolic acidosis that results from the changing dietary habits could be corrected by a shift toward more alkalinizing food. We hypothesize that promoting such a shift can prevent the epidemic of end-stage renal failure in diabetes.
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