Kidney Disease

Study: Diet Plays A Role in Kidney Disease Progression

Diet can be a factor in whether kidney disease advances to kidney failure, according to a new study that found chronic kidney disease patients consuming diets high in animal protein were 3 times more likely to develop kidney failure than those consuming fruit- and vegetable-rich diets.

A team including researchers from the Centers for Disease Control and Prevention, San Francisco General Hospital, and Johns Hopkins University School of Medicine collected data from 1,486 adult patients with chronic kidney disease who took part in the National Health and Nutrition Examination Survey III.

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The researchers asked participants a series of dietary recall questions, in an effort to determine the relationship between high dietary acid load (DAL) and the progression to end-stage renal disease (ESRD) among adults with chronic kidney disease. The authors note that small clinical trials have shown that a reduction in DAL improves kidney injury and slows kidney function decline, but that the relationship between DAL and the risk of ESRD in a population-based cohort remained unexamined.

In total, 311, or 20.9%, of participants developed ESRD, with higher levels of DAL associated with an increased risk of ESRD. The authors note that the human body metabolizes the animal proteins in red meat into acids. While the kidneys produce substances to help the body clear out this acid, these substances can negatively affect kidney function if they remain at high levels in the body for long periods of time. While pointing out that studies have not yet shown a connection between eating a diet high in fruits and vegetables and the prevention of kidney disease, this type of diet does help lower blood pressure, which benefits patients with chronic kidney disease.

The findings “add to the body of evidence supporting recommendations the dietary recommendations in the clinical care guidelines for managing patients with chronic kidney disease,” says Tanushree Banerjee, PhD, a research specialist in the department of medicine, division of general internal medicine at San Francisco General Hospital, and lead author of the study.

Together with other healthcare professionals such as health educators and dietitians, primary care providers should be “an integral part of the multidisciplinary team managing CKD patients,” says Banerjee.

“Nutritional interventions based on higher intake of low acid foods such as fruits and vegetables can be instituted in patients with CKD,” says Banerjee, adding that resources such as Making Sense of CKD: A Concise Guide for Managing Chronic Kidney Disease in the Primary Care Setting are available from the National Kidney Disease Education Program to “assist primary care providers and other healthcare providers better manage—including [managing] diet—and educate CKD patients.”

—Mark McGraw


Banerjee T, Crews D, et al. High Dietary Acid Load Predicts ESRD among Adults with CKD. Journal of the American Society of Nephrology. 2015.