Skip to main content
SpringerLink
Log in

Higher dietary acid load is associated with the risk of hyperuricemia

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Dietary acid load plays a key role in regulating serum uric acid levels. We hypothesized that dietary acid load indices would be positively associated with the odds of hyperuricemia. We aimed to test this hypothesis in a representative sample of Iranian adult population.

Methods

In this cross-sectional study, a total of 6145 participants aged 35–65 years were recruited from MASHAD cohort study. Dietary intakes were assessed using a 24-h dietary recall. Diet-based acid load was assessed as the potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). Hyperuricemia was defined as serum uric acid greater than the 75th percentile. Multivariable logistic regression models were applied to determine the association between diet-based acid load scores and hyperuricemia.

Results

The mean age of participants was 48.89 ± 8.09 years. Overall, 25.7% had hyperuricemia. According to the full-adjusted model, there was a significant association between higher tertile of PRAL, and DAL and hyperuricemia (Q3 PRAL; OR (95% CI): 1.23 (1.05–1.43), Q3 DAL; OR (95% CI): 1.22 (1.05–1.42)). Regarding NEAP, there was no significant association with hyperuricemia. We also found that dietary intake of total sugars, fiber, calcium, and magnesium was associated with the odds of hyperuricemia in our population.

Conclusion

This study showed a significant positive association between two indicators of dietary acid load (PRAL, and DAL) and odds of hyperuricemia among Iranian adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to university data ownership policies, but are available from the corresponding author on reasonable request.

References

  1. Borghi C, Piani F (2020) Uric acid and estimate of renal function. Let’s stick together. Int J Cardiol 310:157–158. https://doi.org/10.1016/j.ijcard.2020.01.046. (in eng)

    Article  PubMed  Google Scholar 

  2. Maiuolo J, Oppedisano F, Gratteri S, Muscoli C, Mollace V (2016) Regulation of uric acid metabolism and excretion. Int J Cardiol 213:8–14. https://doi.org/10.1016/j.ijcard.2015.08.109. (in eng)

    Article  PubMed  Google Scholar 

  3. Benn CL et al (2018) Physiology of hyperuricemia and urate-lowering treatments. Front Med 5:160. https://doi.org/10.3389/fmed.2018.00160. (in eng)

    Article  Google Scholar 

  4. George C, Minter DA (2022) Hyperuricemia. In: StatPearls. StatPearls Publishing, Treasure Island

  5. Maloberti A et al (2020) Hyperuricemia and risk of cardiovascular outcomes: the experience of the URRAH (Uric Acid Right for Heart Health) Project. High Blood PressCardiovasc Prev 27(2):121–128. https://doi.org/10.1007/s40292-020-00368-z. (in eng)

    Article  Google Scholar 

  6. Kou F, Yang S, Wang S, Liu M (2021) Association between serum uric acid and major chronic diseases among centenarians in China: based on the CHCCS study. BMC Geriatrics 21(1):231. https://doi.org/10.1186/s12877-021-02185-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Yip K, Cohen RE, Pillinger MH (2020) Asymptomatic hyperuricemia: is it really asymptomatic? Curr Opin Rheumatol 32(1):71–79

    Article  CAS  PubMed  Google Scholar 

  8. Skoczyńska M, Chowaniec M, Szymczak A, Langner-Hetmańczuk A, Maciążek-Chyra B, Wiland P (2020) Pathophysiology of hyperuricemia and its clinical significance—a narrative review. Reumatologia 58(5):312–323. https://doi.org/10.5114/reum.2020.100140. (in eng)

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zhang W et al (2006) "EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 65(10):1312–1324. https://doi.org/10.1136/ard.2006.055269. (in eng)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Danve A, Sehra ST, Neogi T (2021) Role of diet in hyperuricemia and gout. Best Pract Res Clin Rheumatol 35(4):101723. https://doi.org/10.1016/j.berh.2021.101723. (in eng)

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kanbara A, Miura Y, Hyogo H, Chayama K, Seyama I (2012) "Effect of urine pH changed by dietary intervention on uric acid clearance mechanism of pH-dependent excretion of urinary uric acid. Nutr J 11:39. https://doi.org/10.1186/1475-2891-11-39. (in eng)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Esche J, Krupp D, Mensink GB, Remer T (2020) Estimates of renal net acid excretion and their relationships with serum uric acid and hyperuricemia in a representative German population sample. Eur J Clin Nutr 74(Suppl 1):63–68. https://doi.org/10.1038/s41430-020-0688-2. (in eng)

    Article  CAS  PubMed  Google Scholar 

  13. Esche J, Krupp D, Mensink GBM, Remer T (2018) Dietary potential renal acid load is positively associated with serum uric acid and odds of hyperuricemia in the German adult population. J Nutr 148(1):49–55. https://doi.org/10.1093/jn/nxx003. (in eng)

    Article  PubMed  Google Scholar 

  14. Ghayour-Mobarhan M et al (2015) Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation. Int J Public Health 60(5):561–572. https://doi.org/10.1007/s00038-015-0679-6. (in eng)

    Article  PubMed  Google Scholar 

  15. James WPT, Schofield EC (1990) Human energy requirements. A manual for planners and nutritionists. Oxford University Press

    Google Scholar 

  16. Bolton-Smith C, Woodward M, Tunstall-Pedoe H (1992) The Scottish Heart Health Study. Dietary intake by food frequency questionnaire and odds ratios for coronary heart disease risk. II. The antioxidant vitamins and fibre. Eur J Clin Nutr 46(2):85–93

    CAS  PubMed  Google Scholar 

  17. Organization WH (1985) Energy and protein requirements: report of a joint FAO/WHO/UNU expert consultation. In: Energy and protein requirements: report of a joint FAO/WHO/UNU expert consultation, 1985, pp 206–206

  18. Pedone C et al (2010) Quality of diet and potential renal acid load as risk factors for reduced bone density in elderly women. Bone 46(4):1063–1067. https://doi.org/10.1016/j.bone.2009.11.031. (in eng)

    Article  CAS  PubMed  Google Scholar 

  19. Scialla JJ et al (2011) Estimated net endogenous acid production and serum bicarbonate in African Americans with chronic kidney disease. Clin J Am Soc Nephrol 6(7):1526–1532. https://doi.org/10.2215/cjn.00150111. (in eng)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Scialla JJ, Anderson CA (2013) Dietary acid load: a novel nutritional target in chronic kidney disease? Adv Chronic Kidney Dis 20(2):141–149. https://doi.org/10.1053/j.ackd.2012.11.001. (in eng)

    Article  PubMed  PubMed Central  Google Scholar 

  21. Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 93(1):62–66. https://doi.org/10.1016/s0022-3476(78)80601-5. (in eng)

    Article  CAS  PubMed  Google Scholar 

  22. Shao SS, Lin CZ, Zhu YF, Chen C, Wu QJ, Chen RR (2022) "Higher dietary acid load is associated with hyperuricemia in Chinese adults: a case-control study. BMC Endocr Disord 22(1):286. https://doi.org/10.1186/s12902-022-01192-3. (in eng)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Shin D, Lee KW (2021) Dietary acid load is positively associated with the incidence of hyperuricemia in middle-aged and older korean adults: findings from the Korean Genome and Epidemiology Study. Int J Environ Res Public Health 18(19):10260. https://doi.org/10.3390/ijerph181910260

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sorensen LB, Levinson DJ (1975) Origin and extrarenal elimination of uric acid in man. Nephron 14(1):7–20. https://doi.org/10.1159/000180432. (in eng)

    Article  CAS  PubMed  Google Scholar 

  25. Mandal AK, Mount DB (2015) The molecular physiology of uric acid homeostasis. Annu Rev Physiol 77:323–345. https://doi.org/10.1146/annurev-physiol-021113-170343. (in eng)

    Article  CAS  PubMed  Google Scholar 

  26. Mount DB, Kwon CY, Zandi-Nejad K (2006) Renal urate transport. Rheum Dis Clin N Am 32(2):313, vi-vi331. https://doi.org/10.1016/j.rdc.2006.02.006. (in eng)

    Article  Google Scholar 

  27. Lowry M, Ross BD (1980) Activation of oxoglutarate dehydrogenase in the kidney in response to acute acidosis. Biochem J 190(3):771–780. https://doi.org/10.1042/bj1900771. (in eng)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Curthoys NP, Moe OW (2014) Proximal tubule function and response to acidosis. Clin J Am Soc Nephrol CJASN 9(9):1627–1638. https://doi.org/10.2215/cjn.10391012. (in eng)

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The support provided by Mashhad University of Medical Sciences (MUMS) to conduct this study is highly acknowledged.

Funding

This work was supported by the Vice chancellor of Research of Mashhad University of Medical Sciences.

Author information

Author notes

  1. Najmeh Seifi, Hossein Bahari are equally contributed as first author.

Authors and Affiliations

  1. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran

    Najmeh Seifi, Mina Nosrati, Arezoo Rastegarmoghadam-Ebrahimian, Malihehsadat Abedsaeidi & Majid Ghyour-Mobarhan

  2. Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

    Hossein Bahari

  3. School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran

    Glareh Koochakpoor

  4. Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran

    Zahra Alizadeh Hassani

  5. Division of Medical Education, Brighton &Amp, Sussex Medical School, Falmer, Brighton, Sussex, UK

    Gordon A. Ferns

  6. Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Majid Ghyour-Mobarhan

Authors
  1. Najmeh Seifi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hossein Bahari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mina Nosrati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Glareh Koochakpoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zahra Alizadeh Hassani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arezoo Rastegarmoghadam-Ebrahimian
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Malihehsadat Abedsaeidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gordon A. Ferns
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Majid Ghyour-Mobarhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study concept and design: NS and MG; Data collection: MN and H.B; data analysis and interpretation of data: GK and ZAH and MA; drafting of the manuscript: AR, HB, and NS; supervision and critical revision: GAF, and MG. All authors have approved the final article.

Corresponding author

Correspondence to Majid Ghyour-Mobarhan.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare.

Ethics Approval and Consent to Participate

All experiments were performed in accordance with the declaration of Helsinki and Mashhad University of Medical Sciences ethical guidelines and regulations. The research protocol was approved by the School of Medicine, Mashhad University of Medical Sciences, Biomedical Research Ethics Committee (IR.MUMS.MEDICAL.REC.1398.228). All participants signed a written informed consent before participating in the study.

Consent for Publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seifi, N., Bahari, H., Nosrati, M. et al. Higher dietary acid load is associated with the risk of hyperuricemia. Int Urol Nephrol 56, 1743–1749 (2024). https://doi.org/10.1007/s11255-023-03876-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-023-03876-8

Keywords

Search

Navigation