Kidney Week 2025 Annual Meeting-Exploring Dietary, Exercise, and Microbiome Interventions in CKD

Video Transcription

Video Summary

The session “Exploring Dietary, Exercise and Microbiome Interventions in CKD” featured several studies examining diet, exercise, and gut-targeted approaches to improve kidney and cardiovascular outcomes.<br /><br />A 10-year randomized trial in 108 non-diabetic patients with stage 3 CKD and proteinuria compared dietary acid reduction using fruits/vegetables, sodium bicarbonate, or usual care. Both alkali approaches reduced composite adverse outcomes versus usual care, but fruits and vegetables produced the best long-term results, including lower blood pressure, lower albuminuria, higher eGFR at 10 years, and the strongest reduction in need for kidney replacement therapy.<br /><br />Using NIH MoTrPAC proteomics, investigators showed chronic exercise training upregulated kidney proteins involved in fatty-acid metabolism, particularly peroxisomal beta-oxidation pathways. In a high-fat diet mouse model, exercise lowered serum creatinine and reduced tubular injury and lipid accumulation, while restoring peroxisomal FAO proteins (e.g., ACOX1), suggesting a protective metabolic mechanism.<br /><br />A large Chinese real-world retrospective cohort study found statin initiation was associated with reduced risk of kidney stone progression, especially when cholesterol was well controlled.<br /><br />In the Plant-CKD randomized trial (advanced CKD, eGFR ~13), a 70% plant-based protein diet for 4 weeks significantly reduced the gut-derived toxin TMAO and shifted gut microbiota toward more beneficial taxa, without increasing serum potassium.<br /><br />CRIC cohort analyses linked higher dietary magnesium and potassium intake to lower mortality; associations with kidney failure were mainly seen in participants with eGFR ≥30.<br /><br />Additional talks introduced a new ex vivo kidney-slice respiratory assay for regional metabolism and mouse data showing specific Bacteroides species improved microalbuminuria and inflammatory/metabolic pathways. A final trial reported common amino-acid deficiencies in CKD and diet-driven shifts in serum amino-acid profiles.

Asset Subtitle

Moderator(s): Brandon Kistler, Holly Kramer

Presentation(s):

Dietary Acid Reduction with Fruits and Vegetables or Sodium Bicarbonate to Prevent Composite Adverse Outcomes in Patients with CKD Stage 3: A Ten-Year Randomized Trial - Nimrit Goraya
Exercise Training Drives Proteomic Changes in Male Kidneys and Protects from High-Fat Diet-Induced Kidney Injury: A MoTrPAC Study - Takaaki Higashihara
Exercise Sensitizes the Pressure Diuresis Response - Sophia Sears
Statin Initiation and Risk of Kidney Stone Progression - Xiao Bi
Effects of a Plant-Dominant Protein Diet on Uremic Toxins and Gut Microbiota in Patients with CKD: The PLANT-CKD Trial - Ryuta Uwatoko
Association of Dietary Magnesium (Mg2+) and Potassium (K+) Intake with Mortality and Kidney Failure in the CRIC Study - Margaret Gillis
Development of a Standardized Method for Ex Vivo Respirometry in Intact Kidney Tissue to Assess Regional Metabolism - Ryoichi Bessho
Manipulation of Gut Microbiota Ameliorates Microalbuminuria in Mouse Model via Metabolic and Inflammatory Blood-Gut-Kidney Cross-Talk: An Integrative Single-Cell and Spatial Transcriptome Analysis - I-Wen Wu
Amino Acid Composition and Dietary-Induced Changes in Patients with CKD - So Mi Kim

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/8/2025

Pathway 1 Other

Session ID 519884

Keywords

chronic kidney disease (CKD)

dietary acid reduction

fruits and vegetables intervention

sodium bicarbonate therapy

exercise training proteomics

peroxisomal beta-oxidation (FAO)

high-fat diet kidney injury model

statins and kidney stone progression

plant-based protein diet (Plant-CKD)

TMAO gut-derived uremic toxin

dietary magnesium and potassium intake

gut microbiome Bacteroides and microalbuminuria