Abstract
Dietary acid load (DAL) is a factor that predisposes individuals to the development of urolithiasis (UL). A cross-sectional study was conducted including individuals with UL (n = 53). We estimated DAL using the net endogenous acid production (NEAP) (90.6 [68.8–110] mEq/d), potential renal acid load (PRAL) (13 [0.07–20] mEq/d), and net renal acid excretion (NAE) (45 [30–55.3] mEq/d) indices in individuals with UL. Compared with females, male participants had higher NEAP, PRAL and NAE (p < 0.05). NEAP was associated with potassium, magnesium and lipid intake, body weight (BW), waist circumference (WC), hip circumference (HC), body mass index (BMI), fat mass, muscle mass, systolic blood pressure (SBP), and diastolic blood pressure (DBP). NAE was correlated with total energy, protein, lipid, phosphorus and fluid intake, BW, WC, HC, BMI, waist-to-height ratio, fat mass, muscle mass, SBP and DBP, and PRAL with total energy, protein, lipid, calcium, and phosphorus intake, as well as BW, WC, HC, muscle mass, and SBP.
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References
Medina-Escobedo M, Zaidi M, Real-de León E, Orozco-Rivadeneyra S. Urolithiasis prevalence and risk factors in Yucatán, México. Salud Publica Mex. 2002;44:541–5. https://doi.org/10.1590/s0036-36342002000600006
Wollin DA, Skolarikos A, Preminger GM. Obesity and metabolic stone disease. Curr Opin Urol. 2017;27:422–7. https://doi.org/10.1097/MOU.0000000000000427
Zomorodian A, Li X, Poindexter J, Maalouf NM, Moe OW, Sakhaee K. Acute effect of high fat intake on urinary acidification parameters. Kidney Int Rep. 2025;10:2213–21. https://doi.org/10.1016/j.ekir.2025.04.020
Wieërs MLAJ, Beynon-Cobb B, Visser WJ, Attaye I. Dietary acid load in health and disease. Pflug Arch. 2024;476:427–43. https://doi.org/10.1007/s00424-024-02910-7
Frassetto LA, Todd KM, Morris RC, Sebastian A. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr. 1998;68:576–83. https://doi.org/10.1093/ajcn/68.3.576
Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc. 1995;95:791–7. https://doi.org/10.1016/S0002-8223(95)00219-7
Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356–61. https://doi.org/10.1093/ajcn/59.6.1356
Trinchieri A, Lizzano R, Marchesotti F, Zanetti G. Effect of potential renal acid load of foods on urinary citrate excretion in calcium renal stone formers. Urol Res. 2006;34:1–7. https://doi.org/10.1007/s00240-005-0001-9
Betz MV, Penniston KL. Primary contributors to dietary acid load in patients with urolithiasis. J Ren Nutr. 2023;33:53–8. https://doi.org/10.1053/j.jrn.2022.05.005
Haghighatdoost F, Sadeghian R, Clark CCT, Abbasi B. Higher dietary acid load is associated with an increased risk of calcium oxalate kidney stones. J Ren Nutr. 2021;31:467–74. https://doi.org/10.1053/j.jrn.2020.08.012
Medina-Escobedo M, Alcocer-Dzul R, López-López J, Salha-Villanueva J. Obesity as a risk factor for metabolic disorders in adults with urolithiasis. Rev Med Inst Mex Seguro Soc. 2015;53:692–7
Medina-Escobedo M, Franco-Bocanegra D, Villanueva-Jorge S, González-Herrera L. The I550V polymorphism in the renal human sodium/dicarboxylate cotransporter 1 (hNaDC-1) gene is associated with the risk for urolithiasis in adults from Southeastern, Mexico. Open J Genet. 2013;03:59–66. https://doi.org/10.4236/ojgen.2013.32a3009
Medina-Escobedo M, González-Herrera L, Villanueva-Jorge S, Martín-Soberanis G. Metabolic abnormalities and polymorphisms of the vitamin D receptor (VDR) and ZNF365 genes in children with urolithiasis. Urolithiasis. 2014;42:395–400. https://doi.org/10.1007/s00240-014-0683-y
Wang W, Fan J, Huang G, Li J, Zhu X, Tian Y, et al. Prevalence of kidney stones in mainland China: A systematic review. Sci Rep. 2017;7:41630. https://doi.org/10.1038/srep41630
Parmenter BH, Dymock M, Banerjee T, Sebastian A, Slater GJ, Frassetto LA. Performance of predictive equations and biochemical measures quantifying net endogenous acid production and the potential renal acid load. Kidney Int Rep. 2020;5:1738–45. https://doi.org/10.1016/j.ekir.2020.07.026
Funding
We are grateful to Servicios de Salud del Instituto Mexicano del Seguro Social para el Bienestar (IMSS-BIENESTAR) for the support and re and Delia Sansores-España (CVU 552676) received a scholarship from SECIHTI
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These authors contributed equally: Brenda Pacheco-Hernández, Karina Margarita Pérez-Noh
Authors and Affiliations
Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Servicios de Salud del Instituto Mexicano del Seguro Social para el Bienestar (IMSS-BIENESTAR), Mérida, Yucatán, México
Brenda Pacheco-Hernández, Karina Margarita Pérez-Noh, Delia Sansores-España, Rodolfo Chim-Aké, Ana Ligia Gutiérrez-Solis, Roberto Lugo & Azalia Avila-Nava
Centro De Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A.C. Subsede Sureste, Parque Científico Tecnológico de Yucatán, Sierra Papacal-Chuburná Puerto, Mérida, Yucatán, México
Brenda Pacheco-Hernández & Teresa del Rosario Ayora-Talavera
Escuela de Salud, Universidad Modelo, Mérida, Yucatán, México
Karina Margarita Pérez-Noh & Delia Sansores-España
Departamento Metodología de Investigación, Instituto Nacional de Pediatría, Ciudad de México, México
Isabel Medina-Vera
Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Martha Guevara-Cruz
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
Irma Isela Aranda-González
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Contributions
B.P.-H., K.M.P.-N. and A.A.-N. contributed to conceptualization; B.P.-H., D.S.-E., R.C.-A and K.M.P.-N data collection and analysis, I.M.-V., A.L.G.-S and D.S.-E. were involved in review; B.P.-H., I.M.-V., A.L.G.-S and A.-N.A. wrote the original draft; T.R.A-T., MG-C, R.L., I.I.A.-G, Rand A.L.G.-S review/Editing of manuscript before submission; R.L, A.A.-N, I.A.-G supervision. All authors have read and agreed to content of the manuscript
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This study study has been performed in accordance with the Declaration of Helsinkiand and approved by the Ethics Committee of the Hospital Regional de Alta Especialidad de la Península de Yucatán, IMSS-BIENESTAR (No. 2020-022). Written informed consent was obtained from all participants
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Pacheco-Hernández, B., Pérez-Noh, K.M., Sansores-España, D. et al. Dietary determinants of acid load in a population with urolithiasis from Yucatán, Mexico.
Eur J Clin Nutr (2026). https://doi.org/10.1038/s41430-026-01790-7
Received:22 September 2025
Revised:03 July 2026
Accepted:17 July 2026
Published:25 July 2026
Version of record:25 July 2026
DOI
:https://doi.org/10.1038/s41430-026-01790-7
