Uromodulin is the most abundant urinary protein in healthy subjects which under physiological conditions protects against kidney stone formation. Acid-base imbalances, especially states with acidic urine, increase the risk for uric acid and oxalate stones, but lower it for phosphate-containing stones. Whether habitual high acid loads and high dietary phosphorus intake (P-In) themselves may influence plasma uromodulin concentrations in the long-term is not known.Methods: we prospectively examined biomarker-based the associations of P-In and endogenous acid loads of 3-17 years old healthy participants (n=358) of the DONALD study (Dortmund, Germany) with their circulating uromodulin levels later in adulthood.