For kidney patients with acid buildup, a decade-long trial suggests that fruits and vegetables may offer what standard treatment doesn’t: fewer hospital visits without higher overall costs.
When the kidneys lose their ability to function properly, the consequences can go far beyond the accumulation of waste. People with chronic kidney disease may also develop excess acid in their blood, a condition known as metabolic acidosis that can contribute to worsening kidney function and other serious complications. Doctors typically treat this imbalance with sodium bicarbonate, but new research suggests that a surprisingly simple dietary approach may provide greater long-term benefits.
During a decade-long clinical trial, researchers found that patients who received fruits and vegetables to help neutralize excess acid experienced significantly fewer hospitalizations and emergency room visits than those receiving usual care. Oh
Over 10 years, the 36 patients in the dietary group had only 14 hospitalizations and 20 emergency room visits, compared to 64 and 88, respectively, among the 36 patients receiving usual care. Only four patients in the dietary group required dialysis, compared with 16 in the usual care group, raising intriguing questions about the role of nutrition in protecting kidney health.
Two acid treatments, different long-term results
The trial included 108 adults with stage 3 chronic kidney disease (CKD) and metabolic acidosis, the medical term for excess acid buildup in the body. Researchers randomly divided participants into three groups of 36 people, receiving fruits and vegetables, oral sodium bicarbonate, or usual care. The dietary approach used base-producing fruits and vegetables, which help combat acidity. Both the dietary treatment and sodium bicarbonate aimed to cut dietary acid in half, allowing researchers to compare two approaches with the same acid reduction goal.
Participants were followed annually for 10 years. Across the three groups, researchers recorded 115 hospitalizations and 166 emergency room visits, and 34 patients required dialysis. Although it shares the acidity-reducing goal of dietary treatment, sodium bicarbonate showed no difference from usual care in hospitalizations, emergency department visits, or progression to dialysis.
Kidney benefits without higher overall costs
“Treating 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 costs to the health care system or society,” said corresponding author Nimrit Goraya, MD, of Baylor Scott and White Health.
The results will be presented during ASN Kidney Week 2026, October 22-25. Comparing individual treatments in the trial also raises the question of how dietary interventions might affect care and spending in a broader population.
“These findings support the evaluation of dietary interventions in the treatment of chronic kidney disease, not only at the individual patient level, but also at the population level, where the cumulative clinical and economic benefits can be substantial. 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.”
Meeting: ASN Kidney Week
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