A daily beetroot juice supplement may eventually offer another way to support pregnant women living with chronic kidney disease, but new findings are too preliminary to establish it as a treatment.
In a randomized trial involving 108 pregnant women with chronic kidney disease, researchers found no significant safety concerns associated with drinking nitrate-rich beetroot juice each day. They also recorded fewer serious adverse events among women who received the supplement, along with possible improvements in some maternal and newborn outcomes.
However, the study, which was published in Kidney International Reports, was designed primarily to determine whether a larger clinical trial would be feasible. It was not large enough to prove that beetroot juice preserves kidney function, prevents pregnancy complications or improves infant health.
Pregnancy increases the workload placed on the kidneys. For women with moderate to severe chronic kidney disease, that added strain can contribute to declining kidney function, high blood pressure, premature delivery and other complications.
Treatment options can also become more limited during pregnancy because some medications commonly used to manage kidney disease are not considered safe for a developing fetus.
“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 author Kate Bramham, a consultant nephrologist at King’s College Hospital and professor at King’s College London.
Researchers recruited women with stage 2 through stage 5 chronic kidney disease from eight hospitals in the United Kingdom. Before 25 weeks of pregnancy, participants were randomly assigned to receive either standard medical care alone or standard care with a daily beetroot juice supplement containing dietary nitrate.
Beetroot is naturally high in nitrate, which the body can convert into nitric oxide. Nitric oxide helps blood vessels relax and widen, potentially improving blood flow and reducing some of the pressure placed on the cardiovascular system and kidneys.
The researchers wanted to determine whether pregnant women with chronic kidney disease could be successfully recruited and retained in a trial, whether they would regularly consume the juice and whether the supplement raised any immediate safety concerns.
No increase in high blood potassium, known as hyperkalemia, was seen among women who received beetroot juice. That finding is notable because people with reduced kidney function are sometimes advised to limit high-potassium foods and beverages. However, the study was too small to establish that beetroot juice is safe for every pregnant woman with kidney disease.
Women should not begin taking beetroot juice or nitrate supplements during pregnancy without speaking with their nephrologist, obstetrician or other qualified health professional. Kidney disease varies considerably in severity and a product that is appropriate for one patient may not be appropriate for another.
The beetroot juice group experienced about 70% fewer serious adverse events overall than the standard-care group, according to the researchers. Roughly half of the serious events that occurred involved newborns.
That difference is encouraging, but serious adverse events were not the trial’s primary outcome. With only 108 participants, a relatively small number of events could produce a large percentage difference between the groups. The result will need to be tested in a larger trial before researchers can determine whether the supplement truly lowers risk.
Researchers also observed possible benefits among women with more advanced kidney disease, including better kidney function after pregnancy, fewer newborn admissions to neonatal care and less need for blood pressure medication during pregnancy.
Those findings should be interpreted as early signals rather than confirmed effects. Some came from subgroup or additional analyses and did not consistently reach statistical significance.
The trial also compared beetroot juice with standard care rather than a placebo beverage. Participants and clinicians knew who received the supplement, which could have influenced certain care decisions or reported outcomes, although laboratory measurements are less susceptible to that type of bias.
“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 Priscilla Smith, a nephrologist and doctoral 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 results do not show that eating beets or drinking commercially available beet juice will produce the same effects. The researchers tested a standardized supplement containing a specified amount of dietary nitrate under medical supervision.
A larger clinical trial would be needed to determine whether nitrate-rich beetroot juice meaningfully reduces kidney decline, pregnancy complications or newborn health risks. Such a study would also provide a clearer picture of safety across different stages and causes of chronic kidney disease.
For now, the findings establish that a larger trial appears possible and offer an early reason to continue investigating the intervention.
“These results are an encouraging first step,” Bramham said.
The study was funded through the Kidney Research UK Stoneygate Research Award.