Print Email Facebook Twitter Dietary acid load and rapid progression to end-stage renal disease of diabetic nephropathy in westernized South Asian people Title Dietary acid load and rapid progression to end-stage renal disease of diabetic nephropathy in westernized South Asian people Author van den Berg, E. Hospers, F.A.P. Navis, G. Engberink, M.F. Brink, E.J. Geleijnse, J.M. van Baak, M.A. Gans, R.O.B. Bakker, S.J.L. Publication year 2011 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. © 2011 Società Italiana di Nefrologia. Subject LifePHS - Pharmacokinetics & Human StudiesEELS - Earth, Environmental and Life SciencesNutritionAmmoniaDiabetic nephropathyEnd-stage renal diseaseMetabolic acidosisProteinuria To reference this document use: http://resolver.tudelft.nl/uuid:d45dbad2-0740-4d56-8782-aa5acb2c4bcd DOI https://doi.org/10.5301/jn.2010.5711 TNO identifier 426513 ISSN 1121-8428 Source Journal of Nephrology, 24 (1), 11-17 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.