Kidney Week

Abstract: FR-PO1084

Glycemic Status in Recruited Participants of the Plant-Focused Nutrition in Diabetic Kidney Disease (PLAFOND) Randomized Controlled Trial

Session Information

• Health Maintenance, Nutrition, and Metabolism
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Tran, Diana, The Lundquist Institute, Torrance, California, United States

Diana Tran, MPH

• Rhee, Connie, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States

Connie Rhee, MD, MS

• Bross, Rachelle, The Lundquist Institute, Torrance, California, United States

Rachelle Bross, MS, PhD, RD, RDN

• Cervantes, Mackenzie Kerr, The Lundquist Institute, Torrance, California, United States

Mackenzie Kerr Cervantes, MS

• Jerman, Nikki, The Lundquist Institute, Torrance, California, United States

Nikki Jerman

• Lopez Pena, Erika, The Lundquist Institute, Torrance, California, United States

Erika Lopez Pena

• Iloenyosi, Arinzechukwu Sean, The Lundquist Institute, Torrance, California, United States

Arinzechukwu Sean Iloenyosi

• Landa, Janet, The Lundquist Institute, Torrance, California, United States

Janet Landa

• Ismail, Adnan M., The Lundquist Institute, Torrance, California, United States

Adnan M. Ismail

• Takahashi, Rina, The Lundquist Institute, Torrance, California, United States

Rina Takahashi, MD, PhD

• Simon, Lewis, The Lundquist Institute, Torrance, California, United States

Lewis Simon, PhD, MPH

• Jiang, Luohua, University of California Irvine, Irvine, California, United States

Luohua Jiang

• Kopple, Joel D., The Lundquist Institute, Torrance, California, United States

Joel D. Kopple, MD, FASN

• Dukkipati, Ramanath B., The Lundquist Institute, Torrance, California, United States

Ramanath B. Dukkipati, MD

• Shah, Anuja P., The Lundquist Institute, Torrance, California, United States

Anuja P. Shah, MD

• Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

Background

Chronic kidney disease (CKD) and diabetes mellitus frequently co-occur, known as Diabetic Kidney Disease (DKD). Dietary management remains controversial in patients with DKD. While low-protein diets are often recommended in CKD, plant-focused diets may raise concerns over protein-energy wasting and glycemic control, and hypoglycemia may develop with low hemoglobin A1c, known as “burnt-out diabetes”.

Methods

We examined glycemic status, using serum glucose and hemoglobin A1c, in the recruited participants of the “Plant Focused Nutrition in DKD” (PLAFOND) randomized controlled trial, with eligibility criteria of documented diagnosis of diabetes and CKD, defined as eGFR <60 ml/min/1.73m2.

Results

In the first 74 recruited patients of the PLAFOND trial, the mean age is 58.6 years; 64% are male, 15% Black American, and 74% Hispanic. The mean eGFR is 29.6 ml/min/1.73m2. The mean random serum glucose is 142 mg/dL and A1c is 7.4%. Table 1 shows patient distribution across CKD stages. Figure 1 shows that more than one-third (36%) of patients had A1c <6.5%. While A1c and glucose correlated (R=0.64, p <0.01 in multivariate models), there was no significant correlation between A1c or glucose with eGFR (R<0.07, p>0.2), but mean A1c in CKD Stages 4 and 5 was significantly lower than that in Stage 3 (p<0.05).

Conclusion

In the first 74 PLAFOND trial patients, hemoglobin A1c tends to be lower than expected with one-third of the patients exhibiting A1c<6.5%. Whether low protein, plant-dominant diet affects glycemic status and burnt-out diabetes will be investigated in the PLAFOND Study.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025x6abjj4b