Kidney Week

Abstract: TH-PO1211

Effect of Plant-Based Diet on BP and Gut Microbiota in Kidney Transplant Recipients (PLANET-KT)

Session Information

• Late-Breaking Research Posters
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Kitpermkiat, Rungthiwa, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Rungthiwa Kitpermkiat, MD

• Tantisattamo, Ekamol, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Ekamol Tantisattamo, MD, MPH, FASN

• Payungporn, Sunchai, Chulalongkorn University Department of Biochemistry, Bangkok, Thailand

Sunchai Payungporn

• Shantavasinkul, Prapimporn Chattranukulchai, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Prapimporn Chattranukulchai Shantavasinkul, MD, MHS

• Thotsiri, Sansanee, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Sansanee Thotsiri, MD

• Jariyayothin, Irin, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Irin Jariyayothin, MD

• Kantachuvesiri, Surasak, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

Surasak Kantachuvesiri, MD

Group or Team Name

• Transplant Coordination Team, Ramathibodi Excellence Center for Organ Transplantation.

Background

While a plant-based diet (PBD) is associated with improved kidney health, this benefit in kidney transplant recipients (KTR) is limited. We aim to investigate effect of PBD on BP, allograft function, and gut microbiota composition in KTR.

Methods

A single-center, single-blinded, 1:1 parallel randomized controlled trial (RCT) enrolled kidney transplant recipients (KTR) with stable allograft function ≥3 months post-transplant. Participants were randomized to either a plant-based diet (PBD; intervention) or a habitual diet (control). The control diet provided 0.8 g/kg/day protein and 2–2.3 g/day sodium, while the PBD consisted of the habitual diet with at least one vegetarian meal daily. Inclusion criteria were age ≥18 years and mean systolic blood pressure (SBP) of 120–160 mmHg at randomization, without changes in antihypertensive therapy for ≥1 month. Exclusion criteria included serum sodium <135 mmol/L or potassium >5.5 mmol/L.
The primary outcome was the between-group difference in changes in mean SBP and diastolic blood pressure (DBP) at 6 and 12 weeks, assessed using a linear mixed-effects model including time, group, and their interaction. Secondary outcomes were changes in gut microbiota composition, kidney allograft function, and quality of life (QoL).

Results

Overall characteristics did not differ between groups. The mean age was 46±12 years and 60% were men. Transplant vintage was 2.91 years. Baseline SBP and DBP were 136±11 and 81±9 mmHg, respectively. Among 23 KTR who currently completed 12-week follow-up showed no significant difference in SBP change between groups (mean_diff −2.2 mmHg; 95%CI −12.2, 7.8). The PBD group had a higher baseline creatinine-based eGFR than the control group (74 vs 60 mL/min/1.73 m²). Both groups experienced modest improvements over 12 weeks with no significant between-group difference (mean_diff 2.4 mL/min/1.73 m²; P 0.31). The intervention group exhibited a larger, non-significant reduction in 24-hour urinary sodium, consistent with limited interim power (n=23).

Conclusion

In preliminary analyses, the PBD did not affect changes in SBP or eGFR compared with the habitual diet; however, a non-significant downward trend in 24-hour urinary sodium excretion was observed in the PBD group.

Funding

• Government Support - Non-U.S.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025a0tf4d61