A daily beetroot juice supplement could offer a simple and accessible approach to supporting kidney function during pregnancy for women living with chronic kidney disease (CKD), according to new research led by King's College London.
Pregnancy places extra strain on the kidneys, and for women with moderate to severe CKD, around half will experience a decline in kidney function during pregnancy. Despite these risks, outcomes for pregnant women with CKD have changed little over the past 30 years, and many of the treatments used to manage kidney disease are not safe during pregnancy, meaning women often need to stop their medication for at least nine months.
In the new study, published in Kidney International Reports, researchers investigated whether dietary nitrate from beetroot juice could offer a simple, safe way to support kidney health during pregnancy.
Beetroot juice is naturally rich in nitrate, which the body converts into nitric oxide. Nitric oxide helps widen blood vessels and improve blood flow, leading researchers to investigate whether it could help reduce the strain placed on the kidneys during pregnancy.
The team recruited 108 pregnant women with stage 2-5 chronic kidney disease from eight hospitals across the UK. Participants were randomly assigned to receive either standard care or a daily beetroot juice supplement containing dietary nitrate before 25 weeks of pregnancy.
While the study was designed primarily to assess whether a larger clinical trial would be feasible, the findings also suggested potential benefits for both mothers and babies.
For women living with chronic kidney disease, pregnancy has always meant navigating a difficult trade-off between preserving their own health and keeping their baby safe, often with few tools to do both. These results are an encouraging first step towards a low-cost, low-risk intervention that could genuinely make a difference for this group of women, who have been underserved by research for far too long.
Kate Bramham, Consultant Nephrologist at King's College Hospital, Professor at King's College London and senior author of the paper
Women receiving beetroot juice experienced around 70% fewer serious adverse events overall than those receiving standard care. Of the serious adverse events that did occur, around half affected newborn babies.
Among women with more advanced kidney disease, the researchers also observed trends towards better kidney function after pregnancy, fewer admissions of newborn babies to neonatal care, and a reduced need for blood pressure medication during pregnancy.
Importantly, the researchers found no safety concerns associated with beetroot juice supplementation during pregnancy, including no increase in high blood potassium levels (hyperkalaemia). There have been concerns that beetroot juice could increase the risk of hyperkalaemia in pregnant women with CKD, with some online advice recommending that they avoid it. However, in this study, the authors highlight that no increase in hyperkalaemia was observed among the women receiving beetroot juice.
Pregnancy can put additional stress on the kidneys, and for women with chronic kidney disease there are currently limited options to protect kidney function during this time. Our findings suggest beetroot juice could offer a simple and accessible approach that is safe and worth exploring further.
Dr Priscilla Smith, nephrologist, King's College London PhD student and first author of the study
By increasing nitric oxide production, dietary nitrate from beetroot juice may help improve blood vessel function and support kidney health. These early findings provide an important foundation for future research into protecting women with chronic kidney disease during pregnancy and their babies.
Dr Andrew Webb, Clinical Senior Lecturer at King's College London and co-author of the study
The researchers emphasise that larger clinical trials are now needed to determine whether beetroot juice can significantly reduce kidney function decline and improve long-term outcomes for both mothers and babies.
If confirmed, the intervention could offer an inexpensive and widely available way to support women with chronic kidney disease during pregnancy, when safe treatment options remain limited.
This research was supported by funding from Kidney Research UK.
