effects of a whole-food, plant-based nutrition program on bp and potassium in subjects with ckd

Conditions: Chronic Kidney Diseases

Summary: the purpose of this study is to determine if an educational program emphasizing a whole food plant based diet favorably impacts blood pressure while not significantly increasing blood potassium levels, by comparing a group of patients receiving the educational program with a control group of patients receiving no specific education.

the primary objective of this study is to test the hypothesis that educating hypertensive chronic kidney disease (ckd) stage 3 and 4 patients on the benefit of a whole food plant based (wfpb) diet in the context of a 15-day educational program ("jumpstart program") will lead to improved blood pressure control and will not increase rates of hyperkalemia. other objectives: a) to test the effect of the jumpstart program on degree of uptake on a wfpb diet via a 3 day food recall. b) to test the effect of the jumpstart program on other important outcomes in ckd in the following domains: 1. body composition such as weight and body mass index (bmi). 2. quality of life. 3. laboratory tests including- serum levels of sodium, bicarbonate, chloride, blood urea nitrogen, creatinine, calcium, phosphorus, magnesium, albumin, parathyroid hormone, fibroblast growth factor 23, lipids, c-reactive protein and erythrocyte sedimentation rate. c) to test the effect of the jumpstart program on quality of life in hypertensive ckd patients.

Eligibility criteria:
inclusion criteria: * age greater than 18 years * subjects with ckd 3 and 4 (as determined by an estimated glomerular filtration rate of ≥ 15 ml/min but \< 60 ml/min for at least three months) * subjects with hypertension, defined as use of antihypertension medication: * lack of significant proteinuria ( subjects will have a 24 hour urine protein value of \< 500 mg or a spot protein to creatinine ratio of \< 0.5 or a microalbumin to creatinine ratio \< 300) within previous 3 months. * fluent in english language * able and willing to comply with the testing schedule and the meeting schedule of the jumpstart * able and willing to comply with dietary advice of whole-food plant based diet given during the educational session * able and willing to give informed consent * must have computer/internet access to participate in virtual zoom educational sessions (intervention group only) exclusion criteria: * kidney disease requiring immunosuppressive therapy * diabetes mellitus * pregnancy * life expectancy \< 12 months * history of solid organ transplant or anticipated solid organ transplant in next 2 months * history of hyperkalemia: (two or more potassium levels ≥ 5.0 meq/l or those requiring intervention for high potassium levels within the last six months) * subjects with malabsorptive syndromes * subjects with history of bariatric surgery or planned bariatric surgery in the next 2 months * subjects on warfarin * subjects with documented eating disorder at the time of consent * allergy or intolerance of a plant-based or plant-derived food (gluten, soy, etc.) * following a vegan diet in the six months prior to consent * major surgery within 60 days prior to consent

Keywords: diet plant-based whole food hypertension hyperkalemia blood pressure potassium systolic blood pressure diastolic blood pressure