10-year study links fruits and vegetables to fewer hospital visits in kidney disease

Adults with stage 3 chronic kidney disease and metabolic acidosis who were assigned to eat fruits and vegetables had fewer hospital-related events over 10 years than those receiving usual care, according to findings announced October 22 at the American Society of Nephrology’s Kidney Week in San Diego. The trial also compared a standard kidney medication with usual care, but the dietary approach was the one linked to better long-term results.

What the study compared

Researchers followed 108 patients in three groups of 36. One group was assigned fruits and vegetables, another took sodium bicarbonate, and the third received usual care. The study focused on people with metabolic acidosis, a condition in which acid builds up in the body because damaged kidneys cannot remove it effectively.

According to the report, both active treatments were intended to lower dietary acid by the same amount. That makes the different outcomes notable, because the fruit-and-vegetable group and the medication group were aimed at the same basic problem but did not end up with the same hospital-use pattern.

• Population: adults with stage 3 chronic kidney disease and metabolic acidosis
• Design: three-arm trial with 10 years of follow-up
• Groups: fruits and vegetables, sodium bicarbonate, usual care
• Announcement: October 22 at Kidney Week

Hospital visits were lower in the produce group

By the end of follow-up, the fruit-and-vegetable group had 14 hospitalizations, compared with 64 in the usual-care group. Emergency department visits followed a similar pattern, with 20 in the produce group versus 88 in usual care. The report says those are counts of events, so the same person could account for more than one visit.

Dialysis was counted by patient rather than by event. Four people in the fruit-and-vegetable group required dialysis, compared with 16 in the usual-care group.

The medication group’s results are not laid out in the same level of detail in the source, and the report does not provide a direct statistical comparison between the fruit-and-vegetable group and the sodium bicarbonate group.

Why the findings matter

The trial raises a practical question for patients and clinicians: can changing the diet help people with kidney disease avoid hospital use beyond what standard treatment achieves? The report says the produce approach was linked to fewer long-term hospital events, but it also notes that the mechanism is not clear.

According to the source, sodium bicarbonate is the usual medication used to address excess acid in this setting. Fruits and vegetables may help because they are base-producing foods that can reduce dietary acid load through metabolism-related processes. Still, the report says the data do not show whether the groups reached their acid targets, and it does not include acid measurements or kidney-function results.

Limits of the report

The study was relatively small, and the source describes it as a post hoc analysis, which means the question may have been examined after the trial design was set. That does not make the findings meaningless, but it does mean the results should be read carefully.

Several details that would help readers judge the findings are missing from the report. It does not say which fruits and vegetables were used, how much participants ate, whether the food was supplied or simply recommended, or what “usual care” involved. It also does not give information about participants’ ages, other illnesses, potassium levels, side effects or funding.

For ordinary readers, the practical takeaway is simple: the study suggests diet may play a meaningful role in kidney care, but it does not support making treatment changes on your own. People with kidney disease may need to limit potassium and other nutrients, so any major diet change should be discussed with a clinician first.

Source: Deborah Oladapo