Evidence map›Paper›PMID 23393104›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2013

A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate.

Nimrit Goraya, Jan Simoni, Chan-Hee Jo, Donald E Wesson

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 182 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
182citing papers in PubMed, 10 pooled it
14.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03832166 nacompletednot on this mapstarted 2019, after this paper: background citation

A Prospective, Randomized Two Group Study to Evaluate the Feasibility and Initial Efficacy of a Community-engaged Screening, Identification, and F&V Intervention to Improve F&V Intake and CKD Outcomes in 140 AA Adults

TypeinterventionalSponsorBaylor Research InstituteRan2019 to 2020Enrolled142ConditionsCKD, ESRDArmsFruits and Vegetables, Cooking
NCT04117204 nacompletednot on this mapstarted 2019, after this paper: background citation

Identifying a Cardiorenal Protective Diet in a Lower-income African American Population With Chronic Kidney Disease at Risk for Cardiovascular Disease.

TypeinterventionalSponsorBaylor Research InstituteRan2019 to 2020Enrolled101ConditionsChronic Kidney Diseases, Cardiovascular Diseases, HypertensionArmsFruits and Vegetables
3 · Its place in the literature

Who cites it

182 citing papers in PubMed, 10 syntheses or guidelines pooled it, 402 citations in OpenAlex.

  1. Effects of dietary interventions for metabolic acidosis in chronic kidney disease: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Pooled it
  2. Guideline
  3. Pooled it
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  5. Effects of Treatment of Metabolic Acidosis in CKD: A Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2019
    Pooled it
  6. Racial Disparities and Preventive Measures to Renal Cell Carcinoma.International journal of environmental research and public health · 2018
    Pooled it
  7. Dietary interventions for adults with chronic kidney disease.The Cochrane database of systematic reviews · 2017
    Pooled it
  8. Guideline
  9. Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies.Clinical journal of the American Society of Nephrology : CJASN · 2017
    Pooled it
  10. Pooled it
  11. Trial
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  20. Review

122 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Nimrit GorayaDepartment of Internal Medicine, Texas A&M College of Medicine, Temple, Texas 76508, USA.
Jan Simoni
Chan-Hee Jo
Donald E Wesson
Temple College · USTexas Tech University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesCurrent 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).

resultsPlasma 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.

conclusionsOne 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.

Indexed as

DietFruitVegetablesAcid-Base EquilibriumAcidosisAdministration, OralAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBiomarkersFemaleGlomerular Filtration RateHumansHypertensionKidneyMaleMiddle AgedAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBiomarkersPotassiumSodium Bicarbonate

Identifiers

PMID23393104
PMCPMC3586961
OpenAlexW2131658070

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.