Western diets are not responsible for chronic acid retention: a critical analysis of organic acid and phosphate contribution

AbstractAccording to usual literature, the diet-dependent endogenous production of titratable acidity (TA) is contributed by sulphuric and phosphoric acids (NA) and by metabolizable acids (MAs), representing ‘net-endogenous acid production’ (NEAP). NEAP is mainly neutralised by diet-dependent salts of inorganic cations (), estimated in foods, faeces and urine from inorganic cation–anion difference (NB). It is claimed that urinary loss of organic acids’ anions, ‘’, induces metabolizable H+ ions’ retention. Since ‘’ is normally lost in urine as ‘’ or ‘’, no MA retention takes place. Therefore, in our approach, net acid production (NAP) reduces to endogenous sulphuric acidity only. Since in western diets (WDs) alkaline cations exceed inorganic anions (NB excess), acid excess from phosphorus is neutralized. Moreover, the renal reabsorption of ultra-filtered Pi takes place at ratios greater than ‘4/1’, which means that the kidney operates as a dietary Pi-dependent NB generator ( or ). Since, in standard WDs, H...