Journal Article

The Effects of a Whole-Food Plant-Based Nutrition Education Program on Blood Pressure and Potassium in Chronic Kidney Disease: A Proof-of-Concept Study

Campbell, Thomas M., Wixom, Nellie, Zhang, Anne, Campbell, Erin K., Baran, Andrea, Friedman, Susan M., Barnett, Ted D., Chen, Luojing, Liebman, Scott E., Monk, Rebeca D., Hasan, Shamsul, Sabescumar, Janany, Le, Thu H.

2025

Overview

Background/Objectives: Whole-food plant-based diets (WFPBDs) are beneficial in managing hypertension in the general population but have not been well studied in chronic kidney disease (CKD), potentially due to concerns about hyperkalemia. We hypothesized that individuals with CKD 3 or 4 attending a 15-day WFPBD education program would achieve lower blood pressure compared to those who did not, without an increased risk of hyperkalemia. Methods: This was a pilot trial of 40 subjects with mild-to-moderate CKD and hypertension but without diabetes or proteinuria from a single academic center. The subjects were randomized to the 15-day education program or the control group. The changes in blood pressure, serum potassium, and other anthropometric and biochemical values were assessed. Results: Systolic blood pressure decreased from the baseline to day 15 in the intervention group by 8 mm Hg and increased in the control group by 2.7 mm Hg, although the difference in the blood pressure change did not reach statistical significance (p = 0.12). Diastolic blood pressure was not different between the two groups. Potassium changed by 0.01 mEq/L in the intervention group and −0.07 mEq/L in the control group (p = 0.52). The intervention subjects had significant decreases in body mass (−3.0 vs. −0.12 kg, p < 0.0001), total cholesterol (−39.4 vs. −5.0 mg/dL, p < 0.0001), low-density lipoprotein (−28.4 vs. −0.6 mg/dL, p < 0.0001), and high-density lipoprotein (−8.6 vs. −0.4 mg/dL, p = 0.006) compared to the controls. The changes in albumin and phosphorus were not different between the two groups. Conclusions: The subjects with mild-to-moderate CKD attending a 15-day WFPBD education program had a non-statistically significant reduction in systolic blood pressure without an increased risk of hyperkalemia compared to those who did not attend. The intervention subjects achieved significantly greater reductions in body mass and cholesterol without adverse effects on albumin or phosphorus. Larger and longer-duration trials using this approach in a diverse group of CKD patients are warranted.

• Publisher: MDPI AG,MDPI
• Subject: Adult / Aged / Albumin / Blood Pressure / Cardiovascular disease / Chronic kidney failure / Clinical medicine / Clinical practice guidelines / Creatinine / Diet / Diet therapy / Diet, Plant-Based / Diet, Vegetarian / Energy consumption / Female / Food processing plants / Fruits / Grain / Health education / Humans / Hyperkalemia / Hyperkalemia - etiology / Hyperkalemia - prevention & control / Hypertension / Hypertension - blood / Hypertension - diet therapy / Intervention / Kidney diseases / Legumes / Low density lipoproteins / Male / Medical research / Medicine, Experimental / Middle Aged / Mortality / Nutrition research / Patient Education as Topic - methods / Patients / Pilot Projects / Plant-based foods / Potassium / Potassium - blood / Proof of Concept Study / Recipes / Renal Insufficiency, Chronic - blood / Renal Insufficiency, Chronic - complications / Renal Insufficiency, Chronic - diet therapy / Renal Insufficiency, Chronic - physiopathology