{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:57:31Z","timestamp":1792144651335,"version":"4.4.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,3]]},"abstract":"Summary<\/jats:title>\n \n Background and objectives<\/jats:title>\n \n Current guidelines recommend Na\n +<\/jats:sup>\n -based alkali for CKD with metabolic acidosis and plasma total CO\n 2<\/jats:sub>\n (PTCO\n 2<\/jats:sub>\n ) < 22 mM. Because diets in industrialized societies are typically acid-producing, we compared base-producing fruits and vegetables with oral NaHCO\n 3<\/jats:sub>\n (HCO\n 3<\/jats:sub>\n ) regarding the primary outcome of follow-up estimated GFR (eGFR) and secondary outcomes of improved metabolic acidosis and reduced urine indices of kidney injury.\n <\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n \n Individuals with stage 4 (eGFR, 15\u201329 ml\/min per 1.73 m\n 2<\/jats:sup>\n ) CKD due to hypertensive nephropathy, had a PTCO\n 2<\/jats:sub>\n level < 22 mM, and were receiving angiotensin-converting enzyme inhibition were randomly assigned to 1 year of daily oral NaHCO\n 3<\/jats:sub>\n at 1.0 mEq\/kg per day (\n n<\/jats:italic>\n =35) or fruits and vegetables dosed to reduce dietary acid by half (\n n<\/jats:italic>\n =36).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Plasma cystatin C\u2013calculated eGFR did not differ at baseline and 1 year between groups. One-year PTCO\n 2<\/jats:sub>\n was higher than baseline in the HCO\n 3<\/jats:sub>\n group (21.2\u00b11.3 versus 19.5\u00b11.5 mM;\n P<\/jats:italic>\n <0.01) and the fruits and vegetables group (19.9\u00b11.7 versus 19.3\u00b11.9 mM;\n P<\/jats:italic>\n <0.01), consistent with improved metabolic acidosis, and was higher in the HCO\n 3<\/jats:sub>\n than the fruits and vegetable group (\n P<\/jats:italic>\n <0.001). One-year urine indices of kidney injury were lower than baseline in both groups. Plasma [K\n +<\/jats:sup>\n ] did not increase in either group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n One year of fruits and vegetables or NaHCO\n 3<\/jats:sub>\n in individuals with stage 4 CKD yielded eGFR that was not different, was associated with higher-than-baseline PTCO\n 2<\/jats:sub>\n , 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.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.02430312","type":"journal-article","created":{"date-parts":[[2013,2,8]],"date-time":"2013-02-08T02:41:17Z","timestamp":1360291277000},"page":"371-381","source":"Crossref","is-referenced-by-count":355,"title":["A Comparison of Treating Metabolic Acidosis in CKD Stage 4 Hypertensive Kidney Disease with Fruits and Vegetables or Sodium Bicarbonate"],"prefix":"10.2215","volume":"8","author":[{"given":"Nimrit","family":"Goraya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Simoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan-Hee","family":"Jo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald 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