Background and Objectives: The association between dietary acid load and cardiovascular disease risk has not been examined among patients with diabetic nephropathy (DN). The purpose of the present study was to assess the association between dietary acid load based on potential renal acid load (PRAL) and protein: potassium ratio scores, and cardiovascular disease risk in patients with DN.

 Materials & Methods: In the present cross-sectional study, 547 DN patients were enrolled. A validated food frequency questionnaire was used to assess the dietary intake. Standard methods were also employed to assess the biochemical and anthropometric measures.

Results: The results showed that the low PRAL group had lower hemoglobin (Hb)A1c (5.7% ±0.5% versus 7.8% ± 0.5%; P = 0.01), triacylglycerols (246.9 ± 2.3 mg/dL versus 257.4 ± 2.3 mg/dL; P = 0.006), systolic blood pressure (103.6 ± 0.7 mmHg versus 106.1 ± 0.7 mm Hg; P =0.03), creatinine and fasting blood sugar than the high PRAL group. Pro:K was positively related to HbA1c (5.8% ± 0.5% versus 7.6% ± 0.5%; P = 0.03); however it was inversely associated with low-density lipoprotein and waist circumference.

Conclusion: Both PRAL and Pro:K were positively related to HbA1c in patients with DN. However, biochemical and kidney-related markers depended on the Pro:K and PRAL status.

Keywords: Dietary acid load, Cardiovascular diseases, Diabetic nephropathy