Produce-based diet beats sodium bicarbonate in long-term kidney trial
In a 10-year trial, 108 adults with stage 3 chronic kidney disease and metabolic acidosis were assigned to base-producing fruits and vegetables, oral sodium bicarbonate, or usual care. The produce group had fewer hospitalizations, fewer emergency department visits, and less progression to dialysis than usual care. Sodium bicarbonate did not differ from usual care on those outcomes.
The randomized study enrolled 108 people with stage 3 CKD and metabolic acidosis, dividing them into three equal groups: produce, sodium bicarbonate, or routine care. Each active strategy aimed to cut dietary acid load by half, and participants were checked yearly for a decade.
Over ten years, the produce arm recorded 14 hospital admissions, 20 emergency visits, and four dialysis cases, compared with 64, 88, and 16 under routine care. Sodium bicarbonate outcomes resembled routine care. The work was scheduled for presentation at ASN Kidney Week 2026.
If confirmed, these findings could influence how clinicians discuss diet alongside medication for stage 3 CKD with metabolic acidosis. Patients and caregivers may face new questions about access to produce, meal planning, and long-term adherence. Health systems could consider whether food-based strategies merit study as routine care, though cost, equity, and implementation remain uncertain. The results may also encourage broader nutrition research in kidney disease, but they do not establish produce as a replacement for individualized medical treatment.