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FIGURE 5-2 Hypothesized relationships between certain dietary inorganic electrolytes and bicarbonate, the kidney, essential hypertension, kidney stones, and osteoporosis: the modern diet’s excessive dietary sodium and chloride and deficient dietary potassium and bicarbonate precursors as determinants of both low-grade metabolic acidosis and hypercalciuria and thereby osteoporosis and kidney stones. As formulated, the acidosis can be amplified by impaired renal acidification that occurs as part of the “incomplete syndrome of renal tubular acidosis” (IRTA), an age-related decline in renal function (“age”), or both. The underlined dietary determinants and pathogenic events are those originally hypothesized and depicted. In this scheme, the word “osteoporosis” replaces the term “bone mineralization” specified in the depiction of the original formulation (Modified from MacGregor and Cappuccio [1993] by Morris RC et al. [2001]). Reprinted with permission from Morris RC et al. (2001). Copyright 2001 by Elsevier.

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