People with kidney disease who added more fruits and vegetables to their diet had improved blood pressure and cut their medicine expenses nearly in half compared to those who were treated with a baking soda regimen or did not receive acid-reducing treatment, according to a study presented at the American Heart Association's High Blood Pressure 2016 Scientific Sessions.
"It was remarkable that we achieved better blood pressure control using fewer drugs and without forcing people to change their diet completely. Instead, we provided food for the entire family so they could add fruits and vegetables to what they normally eat. This was important because many of these patients lived in neighborhoods without access to fruits and vegetables through local food banks or grocery stores," said Nimrit Goraya, M.D., study author and program director for nephrology at Baylor Scott & White Health in Temple, Texas.
Diseased kidneys are less able to eliminate acid from the body, which can create abnormally high acid levels in the blood - a condition called metabolic acidosis. People with kidney disease are often treated with sodium bicarbonate, or baking soda, to neutralize this excess acid. Because many fruits and vegetables naturally reduce acid after they are digested, metabolic acidosis can also be treated by increasing those fruits and vegetables in the diet.
In the current study (P265), researchers compared blood pressure control in patients who received acidosis treatment via sodium bicarbonateor fruits and vegetables to patients who did not receive acidosis treatment. Acidosis treatment was intended to cut the acid load on the kidneys by half. All patients (36 in each group) were treated with medications to reduce their systolic (upper number) blood pressure to less than 130 mm Hg.
- After 5 years, the average systolic blood pressure was lower (125 mm Hg) in the fruit and vegetable group than in patients receiving sodium bicarbonate (135 mm Hg) or no acidosis treatment (134 mm Hg).
- Although all groups started the study taking similar doses of common blood pressure drugs, by the end daily doses were lower in the fruit and vegetable group than in patients receiving sodium bicarbonate or no acidosis treatment.
- The average 5-year drug cost for maintaing blood pressure was nearly half in the fruit and vegetable group ($79,760) than the sodium bicarbonate ($155,372) or no treatment groups ($152,305).
"In the long run, adding 3-4 servings of fruits and vegetables to the diet reduces blood pressure and lets people take fewer blood pressure drugs, reducing their medical costs," Goraya said.
In an unrelated study (P120), researchers from the University of São Paulo Medical School, Brazil, analyzed what type of exercise is the most beneficial for kidney disease patients on dialysis.
Data from 28 studies, involving a total of 1,045 patients on dialysis, compared aerobic exercise, resistance (strength) training, or both to control groups. Researchers found that a combination of aerobic exercise and resistance training was the best choice to help patients increase their aerobic fitness and reduce their blood pressure. Both aerobic exercise and the combined training improved aerobic capacity when compared to control groups. However, only the combined training reduced average systolic (top number) blood pressure (-5.88 mm Hg) and diastolic (bottom number) blood pressure (-3.93 mm Hg).
Co-authors of P265 are Jan Simoni, D.V.M., Ph.D.; Jessica Pruszynski, Ph.D.; Pin Xiang, Pharm.D. and Donald Wesson, M.D., M.B.A.
Authors of P210 are Kátia B. Scapini, M.Sc.; Oscar A. Moraes, B.Sc.; Graciele Sbruzzi, M.Sc.; José F. Inácio; Clarissa G. Rodrigues, Ph.D., M.B.A.; Camila P. Leguisamo, M.Sc.; Hugo Tourinho Filho, Ph.D.; Maristela Böhike, Ph.D. and Maria C. Irigoyen, M.D., Ph.D.
Abstract P265: Blood Pressure Control is Better and Less Expensive in Chronic Kidney Disease When Associated Metabolic Acidosis is Treated with Fruits and Vegetables Rather Than Sodium Bicarbonate Nimrit Goraya, Baylor Scott and White Health, Temple, TX; Jan Simoni, Texas Tech Univ Health Sciences Ctr, Lubbock, TX; Jessica Pruszynski, Pin Xiang, Donald Wesson, Baylor Scott and White Health, Temple, TX.