Potential Renal Acid Load (PRAL) is an estimate of the acidity or alkalinity of urine after food has been concerned. Although, the true test needs to be measured by a pH meter. This simple estimate is a reliable indicator. Both for analyzing past food consumption. And for planning alkaline dietary patterns for gout sufferers.
PRAL and Uric Acid Research Topics
PRAL & Uric Acid Diet
My first study looks at statistical relationships between Potential Renal Acid Load and uric acid. Concluding that gout sufferers who cannot tolerate medical uric acid treatment might benefit from dietary patterns that reduce acid load.
Esche, J., Krupp, D., Mensink, G.B. and Remer, T., 2018. Dietary potential renal acid load is positively associated with serum uric acid and odds of hyperuricemia in the German adult population. The Journal of nutrition, 148(1), pp.49-55.
With regard to the nonpharmacologic treatment of persons suffering from elevated SUA [Serum Uric Acid] concentrations and gout, PRAL could perhaps become a useful tool to assess the potential of different diets to lower SUA.
PRAL, Heart Disease, & Uric Acid
My second study compares two groups of women. With one group having uric acid ≥5 mg/dL. And the other group with uric acid below 5 mg/dL. Again, higher Potential Renal Acid Load values were associated with higher uric acid.
Dobrzyńska, M. and Przysławski, J., 2020. The relationship between serum uric acid concentration and cardiovascular risk factors in normotensive postmenopausal women with dyslipidemia. Acta scientiarum polonorum Technologia alimentaria, 19(1), pp.123-131.
PRAL, as a dietary factor, may help estimate the correctness of the diet plan in patients with an increased SUA [Serum Uric Acid] concentration.
PRAL & Gout Comorbidities
Similar to my first one, this study analyzes further details about reducing acid load. With the associated benefit of reduced uric acid. However, it also references other studies. Presenting benefits of lower PRAL for gout sufferers and several comorbidities.
Esche, J., Krupp, D., Mensink, G. and Remer, T., 2020. Estimates of renal net acid excretion and their relationships with serum uric acid and hyperuricemia in a representative German population sample. European Journal of Clinical Nutrition, 74(1), pp.63-68.
This corroborates that a higher acid load to the kidney stemming from a high PRAL diet is potentially SUA-increasing and that a low-PRAL diet, high in fruits and vegetables, may be a useful dietary pattern to lower SUA levels.
I will continue to research studies that cite this one. Alongside other relevant research. In order to present a more complete picture of the benefits of lower PRAL for gout sufferers.
High Acid Load linked to High Uric Acid
Finally, a large study of over 40,000 adults reaffirmed the link between high acid load and high uric acid. Using both common measurements of acid load. Namely, Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP). The study also noted comorbidities associated with high uric acid as:
- Heart Disease
- High Blood Pressure
- Kidney disease
- Metabolic Syndrome
Shin, D. and Lee, K.W., 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. International Journal of Environmental Research and Public Health, 18(19), p.10260.
In conclusion, a higher PRAL and NEAP score was prospectively associated with a higher incidence of hyperuricemia
Your PRAL and Uric Acid Research Story
Which aspects of low acid load are you interested in? How do you think low acid load might help or hinder your gout?
Please tell me your low acid load story in the Gout Forum.
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