A recent study published in The American Journal of Medicine reported the benefits of high fruit and vegetable diets and oral sodium bicarbonate (NaHCO3) for managing hypertension-related chronic kidney disease (CKD) and cardiovascular disease. The randomized trial involved 153 hypertensive patients with macroalbuminuria, who were assigned to one of three groups: a diet rich in fruits and vegetables, oral NaHCO3 supplementation, or usual care.
The study aimed to assess whether dietary acid reduction, through either fruits and vegetables or NaHCO3, could slow the progression of CKD and reduce cardiovascular risks more effectively than standard pharmacologic treatment alone.
Participants in the study were monitored over five years, with the primary outcome being the rate of CKD progression, measured by the estimated glomerular filtration rate (eGFR). Secondary outcomes included changes in cardiovascular risk indices, such as systolic blood pressure, LDL cholesterol, and body mass index (BMI). The fruits and vegetables group received 2 to 4 cups daily of a variety of base-producing fruits and vegetables, while the NaHCO3 group was given tablets designed to match the alkalizing effect of the diet.
The key findings included:
- CKD progression: Both the fruits and vegetables group and the NaHCO3 group showed a slower decline in eGFR compared to the usual care group. Specifically, the mean annual decline in eGFR was -1.08 mL/min/1.73m²/year for the fruits and vegetables group and -1.17 mL/min/1.73m²/year for the NaHCO3 group, compared to -1.94 mL/min/1.73m²/year in the usual care group.
- Cardiovascular outcomes: Participants in the fruits and vegetables group experienced greater reductions in systolic blood pressure and improvements in cardiovascular risk indices compared to both the NaHCO3 and usual care groups. This was observed despite these participants receiving lower doses of antihypertensive and statin medications, indicating the added benefit of dietary intervention.
The study highlights the potential of dietary acid reduction as a key strategy in managing CKD and reducing cardiovascular risks in hypertensive patients. While both interventions (fruits and vegetables, and NaHCO3) were effective in slowing CKD progression, the superior cardiovascular outcomes in the fruits and vegetables group highlight the importance of diet as a foundational approach rather than an adjunctive therapy in hypertension management. The findings suggest that routine dietary management should be considered more in clinical practice, particularly for patients with early-stage CKD and hypertension.
Disclosures: This article was created by the touchCARDIO team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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