Abstract: TH-PO1248
Reducing Dietary Acid with Fruits and Vegetables vs. Oral Alkali in People with CKD (ReDACKD): A Randomized Controlled Feasibility Trial
Session Information
- Late-Breaking Research Posters
October 22, 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
- Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
- Mahboobi, Sepideh, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
- Mollard, Rebecca, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Luhovyy, Bohdan, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Ziaei, Rahele, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Seniuk, Brie, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Leon Mantilla, Silvia Juliana, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Estrella, Maria V., Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Cahill, Leah E., Dalhousie University, Halifax, Nova Scotia, Canada
- Collister, David Thomas Barker, University of Alberta, Edmonton, Alberta, Canada
- Balshaw, Robert, University of Manitoba, Winnipeg, Manitoba, Canada
- Hager, Drew, University of Manitoba, Winnipeg, Manitoba, Canada
- Hingwala, Jay P., University of Manitoba, Winnipeg, Manitoba, Canada
- Tennankore, Karthik K., Dalhousie University, Halifax, Nova Scotia, Canada
- MacKay, Dylan, University of Manitoba, Winnipeg, Manitoba, Canada
Background
Metabolic acidosis is a common complication of chronic kidney disease (CKD) and is associated with accelerated CKD progression. Although current guidelines recommend oral alkali therapy, treatment rates are low, largely because of potential side effects and poor tolerability, such as risk of worsening hypertension. We evaluated the feasibility of providing base-producing fruit and vegetables (F+V) as an alternative approach for managing metabolic acidosis in people with CKD.
Methods
ReDACKD was a dual-center (Winnipeg and Halifax), 1:1 parallel group, randomized controlled feasibility trial with 12-months duration. Participants were randomized to either F+V intervention, provided by weekly grocery delivery, or oral sodium bicarbonate therapy. Eligible adult participants had an estimated glomerular filtration rate (eGFR) of 15-40 ml/min/1.73m2, two consecutive serum bicarbonate measurements of 14-22 mEq/L, and serum potassium <5.3 mmol/L. Feasibility outcomes included recruitment rate, eligibility, and retention. Secondary outcomes included health-related quality of life, physical function, blood pressure and biochemical markers.
Results
Of 56 participants assessed for eligibility, 36 were randomized to either F+V delivery intervention (n=18) or sodium bicarbonate therapy (n=18), and 29 completed the 12-month intervention (13 in F+V arm and 16 in control arm). The ratio of randomized to eligible participants was 36:56 (64.3%), and follow-up outcome data was available for 33:36 (91.7%) of participants. At 12 months, mean serum bicarbonate was 19.9 ± 0.94 mEq/L in the F+V group and 21.5 ± 0.75 mEq/L in the sodium bicarbonate group, compared with 19.6 ± 0.39 and 20.1 ± 0.44 mEq/L, respectively, at baseline. The adjusted between-group difference for serum bicarbonate was -1.26 mEq/L (95% CI: -3.34 to 0.82; p=0.23). No between-group differences were found in other efficacy or safety outcomes including blood pressure, eGFR, serum potassium, HbA1C and urine albumin-to-creatinine ratio (P > 0.1).
Conclusion
Treatment of metabolic acidosis with fruit and vegetable delivery is feasible in people with CKD. Serum bicarbonate concentrations and key safety measures were comparable between the two arms.
Funding
- Government Support - Non-U.S.