Protein intake for the acid-base balance in Chronic Kidney Disease patients, in stages 3 and 4

Abstract

Chronic kidney disease (CKD) is a worldwide health problem and the maintenance of nutrition is an important aspect in preparing the patient for starting dialysis. Metabolic acidosis is a common complication in patients with chronic renal failure in stages 3-5 and is a factor able of producing adverse effects on protein-energy state of these patients. The diet can be an important variable for this acid-base imbalance. It has been questioned whether a high intake of protein foods could provide greater production of acid load and thus contribute to reduced levels of serum bicarbonate, however, there are few details of the influence of dietary components on the metabolic acidosis. Therefore, there is the importance of investigating the quality and quantity of protein intake, as this can contribute to the development of acidosis, which can lead to increased oxidative stress and inflammation, resulting in changes in resting energy expenditure and consequently lead nutritional injury in these patients. The goal of the research project is to determine the protein intake in quantitative and qualitative aspects, and the acid load of the diet that help maintain optimal levels of serum bicarbonate, and characterize protein oxidative stress, inflammation and energy expenditure in patients not on dialysis. Will be assessed in patients not on dialysis stages 3 and 4 CKD, aged 18 years, referred to the Outpatient Service of Nephrology, Hospital das Clinicas, Faculty of Medicine of Ribeirão Preto-USP and not in individualized nutritional counseling. Information will be collected nutritional status (anthropometric, biochemical and dietary intake), protein equivalent of nitrogen appearance, acid load of the diet, protein oxidation, inflammation and energy expenditure. The study aims to provide information that may be useful in developing proposals to improve nutritional care to patients with CKD, to maintain their metabolic stability. (AU)