Fruits and Vegetables Beat Standard Drug in 10-Year Kidney Disease Trial

People with chronic kidney disease who ate base-producing fruits and vegetables to control metabolic acidosis fared better over a decade than those treated with the standard medication, oral sodium bicarbonate, according to results from a randomized clinical trial being presented at ASN Kidney Week 2026 in Denver, October 22–25.

In the trial, 108 adults with stage 3 chronic kidney disease and metabolic acidosis were randomized into three groups of 36 patients each. One group received fruits and vegetables designed to reduce dietary acid by half, a second received oral sodium bicarbonate with the same target of halving dietary acid, and a third received usual care.

The differences in health care utilization and disease progression were substantial. During follow-up, the cohort experienced 115 hospitalizations, 166 emergency department visits, and 34 patients progressed to dialysis. Compared with the usual care group, the fruits and vegetables group had fewer hospitalizations, 14 versus 64, fewer emergency department visits, 20 versus 88, and less progression to dialysis, 4 versus 16 patients. Notably, there was no difference between the sodium bicarbonate group and the usual care group on any of these outcomes, meaning the standard medication did not separate from no targeted treatment at all in this trial.

“Treatment of metabolic acidosis with fruits and vegetables was associated with more favorable long-term clinical outcomes and health care utilization than standard treatment with sodium bicarbonate or usual care, without increasing overall health-system or societal costs,” said corresponding author Nimrit Goraya, MD, of Baylor Scott and White Health.

Goraya emphasized that the implications extend beyond individual treatment decisions. “These findings support evaluating dietary interventions in chronic kidney disease not only at the individual-patient level but also at the population level, where the cumulative clinical and economic benefits may be substantial,” she said. “They also highlight the potential quality-of-life and health-system value of investing in fruits and vegetables as a treatment strategy, particularly when favorable clinical outcomes can be achieved without increasing overall costs.”

The work was presented as a post hoc analysis of a 10-year randomized trial, titled "Long-Term Outcomes and Health Care Costs of Fruits and Vegetables vs. Sodium Bicarbonate or Usual Care for Metabolic Acidosis in CKD: Post Hoc Analysis of a 10-Year Randomized Trial."

Subject of Research: Dietary acid reduction with fruits and vegetables versus sodium bicarbonate for metabolic acidosis in chronic kidney disease

Article Title: Fruits and vegetables outperform medication for treating metabolic acidosis in chronic kidney disease

Article References: Fruits and vegetables outperform medication for treating metabolic acidosis in chronic kidney disease. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: chronic kidney disease, metabolic acidosis, fruits and vegetables, sodium bicarbonate, dialysis, clinical trial, kidney disease diet, ASN Kidney Week 2026, health care utilization, randomized trial, Fruits, vegetables