Based on the premise that acidosis increases kidney angiotensin II, which in turn mediates CKD progression in experimental models,56,79 well-designed clinical studies have sought to test the hypothesis that fruits and vegetables may be effective in reducing metabolic acidosis, kidney angiotensin II, and eGFR decline.80,81 In a recent clinical trial of stage 3 NDD-CKD and normal plasma total CO2 levels (22-24 mmol), 108 patients were randomized to usual care versus interventions to reduce dietary acid by 50% using sodium bicarbonate or fruits and vegetables. This evidence concerns the gene AGT and metabolic acidosis.