Abstract: SA-PO0891
Safety and Efficacy of a Food-Is-Medicine Intervention on Food Insecurity in Patients with CKD
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Hamdan, Hiba, UC Davis Health, Sacramento, California, United States
- Evans, Jennifer Lynn, University of California San Francisco, San Francisco, California, United States
- Plantinga, Laura, University of California San Francisco, San Francisco, California, United States
- Jackson, Katherine, Project Open Hand, San Francisco, California, United States
- Weiser, Sheri D., University of California San Francisco, San Francisco, California, United States
- Palar, Kartika, University of California San Francisco, San Francisco, California, United States
- Tuot, Delphine S., University of California San Francisco, San Francisco, California, United States
Background
Food insecurity affects nearly one-third of patients with chronic kidney disease (CKD) in the US and is associated with poor health outcomes. Food is Medicine (FIM) interventions are gaining momentum to address food insecurity and improve diet quality in patients with chronic diseases, but little is known about the impact and safety of FIM interventions in patients with CKD. FIM interventions rich in fruits and vegetables may raise concerns regarding hyperkalemia, among individuals with CKD. We therefore sought to evaluate the impact of a FIM intervention on food security status and assess the risk of hyperkalemia among CKD patients.
Methods
We pooled data from two randomized controlled trials (CaRDS and CHEFS-DM) evaluating the impact of 5–6 months of medically tailored meals or groceries with nutrition education in patients with heart failure or diabetes respectively. We assessed the association of the intervention with food security status at 6 months (using validated food security screening surveys) and serum potassium at 6–18 months using electronic health record data to evaluate effectiveness and safety of FIM among participants with CKD,defined by an eGFR<60 ml/min, urine albumin creatinine ratio >30 mg/g, or urine protein creatine ratio >150 mg/g at baseline.
Results
Among 138 participants with CKD, 96 were enrolled in the CaRDS trial and 42 in the CHEFS-DM trial. The mean age of participants with CKD was 56.5 years (IQR 49–65.5); 36.2% were female, 34.1% identified as Hispanic, and 31.9% as Black. Nearly half (48.9%) had stage 1 or 2 CKD, 45.0% had stage 3 CKD, and 6.1% had stage 4 CKD. In a random-effects logistic regression model, the FIM intervention was associated with a statistically significant improvement in food security status compared with the control group (adjusted odds ratio [aOR] for food insecurity 0.08, 95% p=0.02). In mixed-effects models, there was no statistically significant effect of FIM on serum potassium compared with controls (β −0.05 mmol/L, p = 0.60). This was also true among a subgroup of patients with CKD stages 3–4, (β = 0.04 mmol/L, p = 0.80).
Conclusion
FIM interventions were effective in reducing food insecurity without increasing the risk of hyperkalemia among patients with mild-to-moderate CKD. Additional FIM trials among patients with advanced CKD are needed to assess the impact of these interventions on clinical outcomes.
Acknowledgment
Authors would like to acknowledge support from the following sources:
CHEFs-DM, funded by the NIH/NIDDK (R01DK124630; Palar/Weiser); and CaRDS, supported by the San Francisco Public Health Department (Palar/Weiser/Nguyen) and the NIH/NIDDK (K01DK107335; Palar).