In stage G 4 hypertensive CKD, a fruit and vegetable diet reduced metabolic acidosis [96], and a similar alkalinizing effect was also demonstrated in a large CKD population, together with a suppression of fibroblast growth factor-23 (FGF-23) [97], although the compensatory decrease in protein intake might as such have caused a decrease in systemic acidification. Here, FGF23 is linked to chronic kidney disease.