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Cited by 410Renal function and acid-base balanceKidney Stones and Urolithiasis TreatmentsChronic Kidney Disease and Diabetes

The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.

A Comparison of Treating Metabolic Acidosis in CKD Stage 4 Hypertensive Kidney Disease with Fruits and Vegetables or Sodium Bicarbonate

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Goraya, Nimrit, Simoni, Jan, Jo, Chan-Hee, Wesson, Donald E.·2013·Clinical Journal of the American Society of Nephrology
DOI 10.2215/cjn.02430312PMC PMC3586961
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Abstract

BACKGROUND AND OBJECTIVES: Current guidelines recommend Na(+)-based alkali for CKD with metabolic acidosis and plasma total CO2 (PTCO2) < 22 mM. Because diets in industrialized societies are typically acid-producing, we compared base-producing fruits and vegetables with oral NaHCO3 (HCO3) regarding the primary outcome of follow-up estimated GFR (eGFR) and secondary outcomes of improved metabolic acidosis and reduced urine indices of kidney injury. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Individuals with stage 4 (eGFR, 15-29 ml/min per 1.73 m(2)) CKD due to hypertensive nephropathy, had a PTCO2 level < 22 mM, and were receiving angiotensin-converting enzyme inhibition were randomly assigned to 1 year of daily oral NaHCO3 at 1.0 mEq/kg per day (n=35) or fruits and vegetables dosed to reduce dietary acid by half (n=36). RESULTS: Plasma cystatin C-calculated eGFR did not differ at baseline and 1 year between groups. One-year PTCO2 was higher than baseline in the HCO3 group (21.2±1.3 versus 19.5±1.5 mM; P<0.01) and the fruits and vegetables group (19.9±1.7 versus 19.3±1.9 mM; P<0.01), consistent with improved metabolic acidosis, and was higher in the HCO3 than the fruits and vegetable group (P<0.001). One-year urine indices of kidney injury were lower than baseline in both groups. Plasma [K(+)] did not increase in either group. CONCLUSIONS: One year of fruits and vegetables or NaHCO3 in individuals with stage 4 CKD yielded eGFR that was not different, was associated with higher-than-baseline PTCO2, and was associated with lower-than-baseline urine indices of kidney injury. The data indicate that fruits and vegetables improve metabolic acidosis and reduce kidney injury in stage 4 CKD without producing hyperkalemia.

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Metadata

Authors
Goraya, N., Simoni, J., Jo, C.-H., & Wesson, D. E.
Affiliations
  • Texas A&M University (US)
  • Baylor Scott & White Medical Center - Temple (US)
Corresponding author
  • Goraya, Nimrit
  • Jo, Chan-Hee
  • Wesson, Donald E.
ORCID
Venue
Clinical Journal of the American Society of Nephrology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-03
Volume
8
Issue
3
Pages
371-381
ISSN
1555-9041 (ISSN-L)
DOI
10.2215/cjn.02430312
PMC
PMC3586961
OpenAlex
W2131658070
Cited by
410
References
37
Citations by year
2026: 14 · 2025: 23 · 2024: 26 · 2023: 34 · 2022: 36 · 2021: 41 · 2020: 40 · 2019: 38 · 2018: 37 · 2017: 36 · 2016: 29 · 2015: 23 · 2014: 22 · 2013: 9
FWCI
20.97
Type
journal article
Language
en
Open access
Locations
  • Clinical Journal of the American Society of Nephrology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Texas Tech University
Topics
  • Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
  • Health Sciences › Medicine › Urology › Kidney Stones and Urolithiasis Treatments
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
metabolic acidosis, chronic kidney disease stage 4, hypertensive nephropathy, sodium bicarbonate, dietary acids, fruits and vegetables, estimated glomerular filtration rate, hyperkalemia, ACE inhibitors
MeSH terms
Acid-Base Equilibrium, Acidosis, Administration, Oral, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Diet, Female, Fruit, Glomerular Filtration Rate, Humans, Hypertension, Kidney, Male, Middle Aged, Potassium, Texas, Time Factors, Vegetables, Biomarkers, Treatment Outcome, Sodium Bicarbonate, Renal Insufficiency, Chronic

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