Protein Renal Acid Load (PRAL)

By,

Ms. Chaitanya. P

Executive Dietician, NephroPlus

PRAL is the amount of acid that is produced in the body after metabolic digestion of certain foods but not the acidic nature of food prior to consuming for ex:- citrus, lemon, oranges and tomatoes etc are acid foods before we consume but there are certain foods which have potential to create more or less acid or more or less alkalinity after digestion and metabolization. These are foods that are positive foods, neutral foods and negative foods.

They are 5 nutrients to determine the potential renal acid load of a food like Protein, Phosphorous, Calcium, Magnesium and Potassium.

Foods high in protein and phosphorous have a high potential renal load and they are more acid forming. Foods lower in protein and phosphorous at the same time which are higher in calcium, magnesium and potassium have lower potential renal acid.

Meats, poultry and seafood – have higher potential renal load
Eggs, diary and whole grains – moderately positive
Legumes, fruits and vegetables – lower & negative potential renal load – these are very alkaline producing foods

WHY DO WE EVEN CARE ABOUT THIS?

Kidneys are responsible for getting rid of excess acid in the body. In people with kidney disease or declined kidney function, acid start to build up and leads to acidosis. Acidosis symptoms include headache, fatigue, muscle loss, poor appetite and weak bones. Acidosis also leads to faster progression of kidney disease. Chronic metabolic acidosis is a common complication in CKD patient.

It is therefore imperative that we ingest the foods that are more positive or higher potential renal acid load than negative or lower potential renal acid load in order to prevent metabolic acidosis as well as to make the kidneys work so hard that it can get rid of that excess acid.

Focus on consuming foods that are moderately positive and having negative potential renal load like increasing our intake of fruits and veggies and lower the intake of especially those highest acid forming foods like meat & poultry. We can balance our meals with maybe some of those lower potential renal acid load foods in order to protect the kidneys from acidosis.
Swapping animal protein with plant protein makes the potential renal acid load lower.