High-Diversity Plant-Based Diet May Benefit Patients with Chronic Kidney Disease

A High-Diversity Plant-Based Diet May Improve Gut Microbiome and Symptom Burden

A diet rich in a variety of plant-based foods may offer therapeutic benefits for individuals with moderate chronic kidney disease (CKD), according to a new randomized controlled trial. The study, conducted in Australia, found that consuming at least 30 different plant foods per week improved diet quality, reduced symptom burden, and positively influenced gut microbiome composition—without causing electrolyte imbalances.

How a Diverse Plant-Based Diet Impacts CKD

The study involved 25 adults with stage 3–4 CKD, who followed two different plant-based diets for six weeks each: a high-diversity plant-based diet (HDPD) with at least 30 unique plant foods per week and a low-diversity plant-based diet (LDPD) with 15 or fewer plant foods per week. Researchers measured changes in uremic toxin levels, diet quality, gut microbiome composition, symptom burden, and other clinical markers.

While overall uremic toxin levels did not decrease consistently across all participants, significant reductions were observed in those with poorer kidney function and higher baseline toxin levels when following the HDPD. Additionally, the HDPD improved gut microbiome diversity, leading to increased production of beneficial metabolites such as butyrate. In contrast, the LDPD was associated with reduced microbial diversity and a decline in several beneficial bacterial species.

What This Means for CKD Care

For CKD patients, dietary strategies that reduce uremic toxins and improve gut health could be key to slowing disease progression and enhancing quality of life. This study suggests that increasing plant food diversity in a CKD-friendly diet may be a safe and effective way to achieve these benefits. Notably, participants following the HDPD reported a lower symptom burden, including reduced constipation, compared to those on the LDPD.

These findings support the potential role of a high-diversity plant-based diet in CKD management. While further research with larger sample sizes is needed, this study highlights the importance of dietary diversity as a factor in improving metabolic and gut health outcomes for individuals with CKD.

Source:

Stanford J, Stefoska-Needham A, Jiang X, McWhinney B, Cheikh Hassan HI, El-Omar E, Charlton K, Lambert K. High-Diversity Plant-Based Diet and Gut Microbiome, Plasma Metabolome, and Symptoms in Adults with CKD. Clin J Am Soc Nephrol. 2025 Mar 17. doi: 10.2215/CJN.0000000682. Epub ahead of print. PMID: 40094861.