Objective:

To examine the effects of dietary interventions on kidney function decline and cardiovascular disease risk in patients with primary hypertension and macroalbuminuria.

Approach:

• Study Design: A 5-year randomized controlled trial involving 153 patients with primary hypertension and macroalbuminuria, assigned to increased fruits and vegetables, sodium bicarbonate supplementation, or usual care.
• Interventions: Participants in the fruits and vegetables group consumed 2 to 4 cups daily of base-producing fruits and vegetables, while the sodium bicarbonate group received 0.4 mmol/kg body weight/day of oral sodium bicarbonate.

Key Findings:

• Both intervention groups showed slower estimated glomerular filtration rate decline compared to usual care.
• Urine albumin-to-creatinine ratio increased less in both intervention groups compared to usual care.
• The fruits and vegetables group achieved lower systolic blood pressure compared to the other groups.
• Greater reductions in LDL cholesterol, Lp(a) cholesterol, and BMI were observed in the fruits and vegetables group.
• Patients in the fruits and vegetables group required lower doses of certain medications compared to usual care.

Interpretation:

Limitations:

• The study had attrition rates with varying numbers of participants completing the follow-up.
• Future studies are needed to assess responses in patients with less severe albuminuria.

Conclusion:

Sources:

• The American Journal of Medicine