Infrequent consumption of fruits and vegetables increases the risk for death in both patients with nondialysis-dependent chronic kidney disease (CKD) and patients on hemodialysis, a new study finds.

In a cohort of 2006 patients (55% men; mean age 69 years), a subset of 902 patients (45%) had non-dialysis-dependent CKD and 131 patients (7%) were on hemodialysis. As many as 53% and 28% of patients with CKD and hemodialysis, respectively, consumed produce every day. During a median follow-up of 5.7 years, 561 patients died.

The consumption of vegetables and fruits progressively decreased from CKD stage 1 to 5 and hemodialysis, Minako Wakasugi, MD, MPH, PhD, of Niigata University Graduate School of Medical and Dental Sciences in Niigata, Japan, and colleagues reported in the Journal of Renal Nutrition.

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In the full cohort, patients who consumed produce never or rarely had a significant 1.6-fold increased risk for all-cause mortality compared with patients who consumed produce every day, regardless of CKD status, comorbidities, hyperkalemia (serum potassium greater than 5.0 mmol/L), and demographic factors. Those who consumed produce sometimes had a significant 1.3-fold higher risk.

At baseline, serum potassium levels were similar by CKD stage, irrespective of the produce consumption group.

“Our results suggest that eating both vegetables and fruits every day may not be associated with increased serum potassium levels, and that it may reduce rather than increase all-cause mortality in patients with CKD including those on [hemodialysis], as has been observed for non-CKD individuals,” the investigators wrote.

Produces’ high fiber content, alkalinizing potential, and reduced bioavailability of potassium may limit serum potassium increases. Since this was an observational study, the investigators could not rule out the possibility that patients with hyperkalemia reduced the frequency of their vegetable and fruit consumption.


Wakasugi M, Yokoseki A, Wada M, et al. Vegetable and fruit intake frequency and mortality in patients with and without chronic kidney disease: a hospital-based cohort study. J Renal Nutr. 2023;33:566-574. doi:10.1053/j.jrn.2023.01.011

This article originally appeared on Renal and Urology News