Recent studies shed light on how patients with chronic kidney disease can manage nutrition and keep blood pressure under control. Nimrit Goraya from Texas A and M College of Medicine and her colleagues investigated whether adding fruits and vegetables to the diet can improve the health of patients with chronic kidney disease (CKD).
Alkaline therapy is used to treat CKD patients with severe metabolic acidosis. Dr. Goraya and his team looked to see if adding fruits and vegetables - which are highly alkaline - can benefit CKD patients with less severe metabolic acidosis.
For the study, 108 patients were randomized to receive added fruits and vegetables, an oral alkaline medication, or nothing. After three years, consuming either fruits and vegetables or the oral medication reduced a marker of metabolic acidosis and preserved kidney function to similar extents.
"Our findings suggest that an apple a day keeps the nephrologist away," Goraya said.
Another team led by Deidra Crews from Johns Hopkins University School of Medicine wondered whether poor dietary habits might help explain why poverty is linked with CKD.
In their study of 2,058 individuals, fibre, calcium, magnesium, and potassium intake were lower, and cholesterol higher, among those in poverty. CKD was present among 5.6 percent of people in poverty, and 3.8 percent of those not in poverty.
"An unhealthy diet is strongly associated with kidney disease among poor individuals. Dietary interventions tailored to meet the needs of this population may help to reduce disparities in kidney disease," Crews said.
A third study looked at blood pressure control among ethnically diverse CKD patients. Racial and ethnic minorities are more likely to develop kidney failure than whites, perhaps due in part to poorer blood pressure control.
Delphine Tuot from the University of California, San Francisco and her colleagues examined blood pressure using 18,864 clinical blood pressure measurements from 6618 adults (23 percent white, 34 percent black, 18 percent Hispanic, 21 percent Asian) with CKD who received primary care in a health network serving San Francisco's uninsured and publicly insured residents.
Blood pressure was nearly 20 percent higher than national estimates with smaller, though still significant, disparities between black and white patients.
"Public health care delivery systems like the Community Health Network of San Francisco disproportionately care for vulnerable patients, including those of racial/ethnic minorities, and can serve as front-line agents to reduce disparities of care through implementation of innovative programs," Tuot said.
The findings of the three studies were presented during the American Society of Nephrology's Annual Kidney Week.