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1.
Arch. venez. pueric. pediatr ; 79(3): 92-98, sep. 2016. tab
Article in Spanish | LILACS | ID: biblio-827845

ABSTRACT

La progresión de la Enfermedad Renal Crónica (ERC) es acelerada por la acidosis metabólica, la cual puede ser agravada por la dieta. El objetivo del presente trabajo fue determinar la Carga Acida Potencial Renal (CAPR) de la dieta en niños con ERC y establecer su relación con el estado ácido base. MÉTODOS: Se incluyeron 26 pacientes (10 meses-17 años) con ERC atendidos en la consulta del Servicio de Nefrología del Hospital de Niños JM de los Ríos entre Junio 2014 y Enero 2016. Para la evaluación dietética se utilizaron: recordatorio de 24 horas y cuestionario de frecuencia. La CAPR fue calculada según Manz y Remer. Parámetros de laboratorio analizados: gases venosos, creatinina, sodio, potasio y cloro séricos. RESULTADOS: La CAPR fue de 16,11±10,6 mEq/día. Ninguno de los pacientes tuvo CAPR negativa. Los resultados para HCO3 y pH séricos fueron 20,46±4,5 mEq/l y 7,3±0,8 mEq/l respectivamente. No se encontró correlación significativa entre la CAPR y los parámetros ácido base, pero sí correlación positiva con la ingesta de proteínas (p=0,001), carnes (p=0,010), grasas (p=0,006) y cereales (p=0,022) y negativa con la ingesta de vegetales (p=0,032). 21 pacientes recibían bicarbonato de sodio como tratamiento alcalinizante sin lograr corregir la acidosis metabólica en la mayoría de los casos. CONCLUSIONES: La CAPR estuvo elevada en la mayoría de los pacientes. No se encontró correlación significativa entre la CAPR y los parámetros ácido base. Es importante la corrección de la acidosis metabólica en estos pacientes mediante bicarbonato de sodio y mayor ingesta de frutas y vegetales.


Progression of chronic kidney disease (CKD) can be accelerated by metabolic acidosis, which may be influenced by diet. The aim of this study was to determine the Potential Renal Acid Load (PRAL) in children with CKD and establish its relationship with acid-base status. METHODS: 26 patients (10 months - 17 years) with CKD who attended the outpatient clinic of the Department of Nephrology at the Children's Hospital JM de los Rios from June 2014 through January 2016 were included. Dietary assessment was performed with a 24-hour recall and frequency questionnaire. PRAL was calculated according to Manz and Remer. Laboratory parameters analyzed were: venous gases, serum creatinine, sodium, potassium and chloride. RESULTS: PRAL was 16.11 ± 10.6 mEq/day. None of the patients had a negative PRAL. The results for serum HCO3 and pH were 20.46 ± 4.5 mEq/l and 7.3 ± 0.8 mEq/l respectively. No significant correlation was found between PRAL and acid-base parameters, although the correlation was significant with protein intake (p = 0.001), and also with meat (p = 0.010), fat (p = 0.006) and cereal (p = 0.022) intake. PRAL was negatively correlated with vegetable intake (p=0.032). 21 patients received sodium bicarbonate as alkalizing treatment without achieving metabolic acidosis control in most cases. CONCLUSIONS: PRAL was elevated in most patients. No significant correlation between PRAL and acid base parameters was found. It is important to achieve adequate metabolic acidosis control in these patients by means of sodium bicarbonate and increased intake of fruits and vegetables.

2.
Arch. venez. pueric. pediatr ; 79(2): 62-68, jun. 2016. tab
Article in Spanish | LILACS | ID: biblio-827838

ABSTRACT

Se ha demostrado que la acidosis metabólica acelera la progresión de la Enfermedad Renal Crónica (ERC) y que la dieta moderna se caracteriza por un elevado contenido de ácidos que podría contribuir con este trastorno metabólico. El objetivo del presente estudio fue estimar la Carga Ácida Potencial Renal (CAPR) en pacientes con ERC atendidos en el Servicio de Nefrología del Hospital de Niños J.M. de los Ríos entre abril de 2014 y febrero de 2016. Método: Se realizó un estudio descriptivo y transversal en 28 niños (10 meses-17 años) con diagnóstico de ERC en estadios 1-4. El estado nutricional se evaluó mediante peso, talla y circunferencia media del brazo y la composición de la dieta mediante cuestionario de frecuencia de consumo y recordatorio de ingesta de 24 horas. La CAPR se calculó por el método de Manz y Remer. Resultados: La talla y el estado nutricional se encontraron por debajo de lo normal en 15 y 9 pacientes respectivamente. Se observó alta ingesta de cereales y carnes, y baja ingesta de vegetales y frutas. Veintidós pacientes consumían una dieta hiperproteica. Se obtuvo una CAPR 16±10,7 mEq/día, con una correlación positiva con la ingesta proteica (p=0,001), raciones de carnes (p=0,010), de cereales (p=0,022), y de grasas (p=0,006), y negativa con la ingesta de vegetales (p=0,032). Conclusiones: El patrón de consumo de los niños con ERC podría contribuir a la progresión de la enfermedad al favorecer la acidosis metabólica. La CAPR debe abordarse como parte del tratamiento nutricional de niños con ERC.


It has been shown that metabolic acidosis accelerates the progression of Chronic Kidney Disease (CKD) and that modern diet is characterized by a high content of acid -forming elements that could contribute to this metabolic disorder. The aim of this study was to estimate the Potential Renal Acid Load (PRAL) in CKD patients attended at the Department of Nephrology at the Children's Hospital J.M. de los Ríos from April 2014 through February 2016. Method: A descriptive cross-sectional study was conducted in 28 children (10 months-17 years) with the diagnosis of CKD in stages 1 , 2, 3 and 4. Nutritional status was evaluated by weight, height and mid-arm circumference, and the diet composition by food frequency questionnaire and 24 hours intake reminder. PRAL was calculated by the method of Manz and Remer. Results: Height and nutritional status were under normal values in 15 and 9 patients respectively. Meat and cereal intake were high, whereas vegetables and fruit intake were low. Protein intake was high in 22 patients. PRAL was 16 ±10.7 mEq/day and a positive correlation was observed with protein intake (p=0,001), daily rations of meat (p=0,010), fat (p=0,006), and cereals (p=0,022), and a negative correlation with vegetable intake (p=0,032). Conclusions: The dietary pattern of children with CKD may contribute to the progression of the disease by promoting metabolic acidosis. PRAL must be addressed as part of the nutritional treatment of children with CKD.

3.
Nutrire Rev. Soc. Bras. Aliment. Nutr ; 40(3): 344-351, set. 2015. tab, ilus
Article in Portuguese | LILACS | ID: biblio-881816

ABSTRACT

OBJECTIVE:To characterize the profile of commercially available mineral waters in Brazil (from national and international sources) by calculating the potential renal acid load (PRAL). METHODS: We evaluated 308 commercially available mineral waters in the five Brazilian macro regions. The content of sulfate, chloride, sodium, potassium, magnesium and calcium from mineral waters were obtained to calculate the PRAL, using Remers & Manz formula, adapted for mineral waters. RESULTS: From the 308 mineral waters collected, 256 were included in this analysis. We found a great variability in the composition of mineral waters according to the source and country of origin. All the components analyzed were present in greater quantities in the mineral waters from international sources and differed significantly from the values found in the mineral waters from Brazilian sources, with the exception of potassium and sodium (Mg: 1,9 vs 6,8, p=0,0008; Ca: 5,78 vs 32,9, p=0,001; SO4: 0,9 vs 13, p<0,0001; Cl: 1,49 vs 12, p=0,0019, mineral waters from Brazilian sources versus international sources, respectively). The PRAL value of mineral waters from Brazilian sources was also statistically different (-0,39 vs -1,39; p=0,0025). The potential basifying / acidifying effects of the mineral water evaluated by PRAL did not correlate with the pH value. The magnesium and bicarbonate content were the major predictors of a negative PRAL - the higher the content thereof, lower the PRAL. CONCLUSION: The mineral waters from Brazilian sources have a low grade of mineralization and the vast majority (n=201) have a PRAL value considered neutral


OBJETIVO: Caracterizar o perfil de águas minerais comercialmente disponíveis em território brasileiro (provenientes de fontes nacionais e internacionais) através do cálculo do potencial de carga ácida renal (PRAL). MÉTODOS: Foram avaliadas 308 águas minerais comercialmente disponíveis nas cinco macrorregiões brasileiras. O conteúdo de sulfato, cloreto, sódio, potássio, magnésio e cálcio das águas minerais foram obtidos para cálculo do PRAL, que foi realizado através da fórmula de Remer e Manz, adaptada para águas minerais. RESULTADOS: Das 308 águas minerais coletadas, foram incluídas 256 nesta análise. Foi encontrada uma grande variabilidade na composição das águas minerais de acordo com a fonte de extração e país de origem. Todos os componentes analisados apresentaram-se em maior quantidade nas águas minerais de fontes internacionais e diferiram significantemente dos valores encontrados nas águas minerais de fontes brasileiras, com exceção do potássio e sódio (Mg: 1,9 vs 6,8, p=0,0008; Ca: 5,78 vs 32,9, p=0,001; SO4: 0,9 vs 13, p<0,0001; Cl: 1,49 vs 12, p=0,0019, fontes brasileiras versus fontes internacionais, respectivamente). O valor de PRAL das águas minerais de fontes brasileiras também foi diferente (-0,39 vs -1,39; p=0,0025). O potencial alcalinizante/ acidificante das águas minerais avaliado pelo PRAL não esteve correlacionado com o valor de pH. O magnésio e bicarbonato apresentaram-se como os principais preditores negativos do PRAL ­ quanto maior o teor destes, menor o PRAL. CONCLUSÃO: As águas minerais de fontes brasileiras possuem baixo grau de mineralização e a maioria (n=201) com valor de PRAL considerado neutro


Subject(s)
Alkalizers/analysis , Brazil , Mineral Waters/analysis , Mineral Waters/therapeutic use
4.
Endocrinology and Metabolism ; : 201-207, 2015.
Article in English | WPRIM | ID: wpr-30193

ABSTRACT

BACKGROUND: In this study we investigated the associations of dietary acid-base load, identified by potential renal acid load (PRAL) and protein to potassium (Pro:K) ratio, with cardiometabolic risk factors in Tehranian adults. METHODS: A cross-sectional study was conducted within the framework of the fourth phase of the Tehran Lipid and Glucose Study (2009 to 2011) on 5,620 men and women aged 19 to 70 years. Dietary data were collected by a trained dietitian using a validated, 147-food item, semi-quantitative food frequency questionnaire, and dietary PRAL and Pro:K ratio were calculated. Multiple linear regression models with adjustment for potential confounding variables were used to evaluate the associations of dietary acid-base load with anthropometric measures, blood pressure, serum triglycerides, high density lipoprotein cholesterol (HDL-C), serum creatinine, and fasting blood glucose. RESULTS: The mean+/-SD age of the participants was 39.8+/-12.8 years and 54% of participants were women. Mean+/-SD PRAL was -22.0+/-29.1; mean PRAL was -15.6 in men and -26.8 in women. Dietary PRAL was associated with weight (beta=0.098, P<0.001), waist circumference (beta=0.062, P<0.01), serum triglycerides (beta=0.143, P<0.01), HDL-C (beta=-0.11, P<0.01), diastolic blood pressure (beta=0.062, P<0.01), and serum creatinine (beta=0.142, P<0.001). Pro:K ratio was associated with weight (beta=0.055, P<0.001), waist circumference (beta=0.04, P<0.01), serum HDL-C (beta=-0.06, P<0.01), serum triglycerides (beta=0.03, P<0.05), diastolic blood pressure (beta=0.026, P<0.05), and serum creatinine (beta=0.07, P<0.01). CONCLUSION: A more acidic dietary acid-base load may be a risk factor for the development of metabolic disorders.


Subject(s)
Adult , Female , Humans , Male , Blood Glucose , Blood Pressure , Cholesterol, HDL , Creatinine , Cross-Sectional Studies , Fasting , Glucose , Linear Models , Nutritionists , Potassium , Risk Factors , Triglycerides , Waist Circumference , Surveys and Questionnaires
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