Beetroot Juice Shows Promise for Pregnant Women With Chronic Kidney Disease

Pregnancy is a demanding time for anyone’s kidneys, but for women who already have chronic kidney disease (CKD), it can be especially dangerous. Nearly half of pregnant women with moderate to severe CKD will end up needing dialysis or lose at least a quarter of their kidney function within a year of delivery, and their babies face elevated rates of complications too. Despite how serious these risks are, doctors have had no targeted treatments to offer these patients, until now.

A new multicenter study out of the United Kingdom, published in Kidney International Reports, tested a surprisingly simple intervention: daily beetroot juice, taken for its natural dietary nitrate content.

Testing a Low-Cost Intervention Across Eight Centers

Researchers enrolled 108 pregnant women with stage G2 to G5 CKD, all less than 25 weeks into pregnancy, across eight U.K. medical centers. Participants were randomly assigned to either standard prenatal care or standard care plus a daily dose of beetroot juice containing 400 milligrams of dietary nitrate. Women already on dialysis and those with major fetal abnormalities, multiple pregnancies or a beetroot allergy were excluded.

Because this was designed primarily as a feasibility study, the main goal was simply proving that a trial like this could recruit patients successfully, which it did, averaging about one participant per site per month.

Encouraging Early Signals

While the study wasn’t statistically powered to prove the treatment works, several patterns stood out. Among women with more advanced kidney impairment before pregnancy, those who drank beetroot juice tended to have lower creatinine levels, a marker of kidney function, both six weeks and six months after delivery, though these differences did not reach statistical significance.

More strikingly, newborns of mothers in the beetroot juice group were less likely to need admission to a neonatal unit or intensive care, 23.3% compared with 39.6% in the standard care group. Serious adverse events were also significantly less common in the beetroot juice group: 23.3% of participants experienced a serious adverse event, compared with 50.9% of those receiving standard care alone. In a secondary analysis, women taking beetroot juice were also less likely to need blood pressure medication during pregnancy, 36.7% versus 66%, respectively.

What Comes Next

The investigators are careful to frame these findings as promising rather than conclusive. Because the study was designed to test feasibility rather than definitively measure effectiveness, the differences in kidney function, though favorable, did not reach statistical significance, and the sample size was small. Still, the reduction in serious adverse events and neonatal intensive care admissions is notable given how few options currently exist for this patient population.

“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,” said first author of the study Priscilla Smith, M.B.B.S., a nephrologist and Ph.D. student at King’s College London. “Our findings suggest beetroot juice could offer a simple and accessible approach that is safe and worth exploring further.”

The team says the next step is a larger, adequately powered randomized controlled trial to confirm whether dietary nitrate truly improves outcomes for pregnant women with kidney disease. In the meantime, the study offers a hopeful signal that an inexpensive, accessible intervention like beetroot juice could eventually become part of standard care for one of pregnancy’s higher-risk populations.

“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,” said senior investigator Kate Bramham, M.B.B.S., Ph.D., consultant nephrologist at King’s College Hospital and professor at King’s College London. “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.”