You’ve heard many times that diet impacts your kidney and overall health. But one way they do this is through managing the acid-base balance of the body. That is what PRAL and CKD is based off of.
Potential renal acid load (PRAL) is a measure of how a food influences the acid or base production in the boy . High in PRAL diets have been shown to induce low-grade metabolic acidosis, or the build up of acid in the body. This causes the kidneys to work harder to filter.
What is PRAL and CKD?
The best diet for CKD progression has not been determined, including foods that are low in PRAL may help to preserve kidney function.
PRAL is calculated from 5 nutrients (protein, phosphorus, potassium, magnesium, and calcium) that create either acid or base environments in our bodies.
Acid during metabolism is produced from protein (the largest influence on PRAL score) and phosphorus. Whereas potassium, magnesium and calcium produce bases.
Higher PRAL values indicate more acid is produced from your food.
Negative PRAL values indicate that base (the opposite of acid) is produced.
PRAL can be calculated using this formula: PRAL = 0.49 x protein (g/day) + 0.037 x phosphorus (mg/d) – 0.021 x potassium (mg/day) – 0.026 magnesium (mg/day) – 0.013 x calcium (mg/day).
The total PRAL of your diet is the balance of the acid and base produced by your diet throughout the day, so it is important to consider the overall diet not just one food item.
Best Low PRAL Foods
So you’ve been reading about the acid-base balance in your body and how food may influence it, it is important to note that your body is constantly striving to keep pH at healthy levels, and is tightly regulated by your lungs and kidneys. In fact, the kidneys get rid of extra acid your diet generates. So the goal is to reduce the acid load on our kidneys by increasing the amount of foods that produce alkali or base environments and reducing overall protein intake.
With CKD, the risk of metabolic acidosis is higher. This occurs when the kidneys cannot get rid of extra acid as well as they should. This causes acid to build up in your blood. Acidosis and has many negative health effects like progression of CKD, weakened bones, inflammation, and taste changes. Following a low PRAL diet can prevent acid build-up and preserve kidney function.
The foods you choose to eat impacts how much acid you have in your body. That is where PRAL comes in. And choosing lower PRAL foods can prevent and treat this metabolic acidosis in CKD. In fact vegetables and fruit are almost as effective as some medications used to treat acidosis.
|High PRAL Foods||Negative PRAL Foods|
|Lamb||Beans & Legumes|
|Chicken & Turkey||Dairy|
|Fish & Seafood|
But picking out high and low PRAL foods can be time consuming. So, start with what is on your plate at each meal.
- Aim to include more vegetables and fruit. These help to lower your acid production as they are more basic.
- Eat the right amount of protein. Limit portions of animal protein, aim for the size of a deck of cards or less, this helps keep your protein in target.
- Choose plant-based proteins more often, these are lower in PRAL and easier for the kidneys to filter.
Are You Looking To Make Nutrition Changes?
Do you want to make changes to your nutrition to preserve your kidney function, then the Kidney Nutrition Fast Track course is here to help get you started.
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