Beetroot Juice May Support Kidney Health During Pregnancy

Researchers found fewer serious complications with daily beetroot juice, but larger studies are needed before it can be routinely recommended.

A daily beetroot juice supplement may help protect kidney function and improve pregnancy outcomes in women living with chronic kidney disease (CKD), according to a new Kidney International Reports study (1^✔ ✔Trusted Source
Randomized Trial of Dietary Nitrate Supplementation in CKD Pregnancy (ORCHARD-BEET)

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Researchers found that pregnant women who consumed nitrate-rich beetroot juice experienced fewer serious adverse events, with encouraging signs of better kidney function after delivery and fewer newborn admissions to neonatal care.

However, larger clinical trials are needed before the approach can be recommended routinely.

Pregnancy places extra strain on the kidneys, making women with CKD more vulnerable to complications such as preeclampsia, preterm birth, fetal growth restriction, and worsening kidney function.

Since many kidney medications cannot be safely used during pregnancy, researchers are increasingly exploring food-based strategies.

Dietary nitrate from beetroot juice may improve nitric oxide production, enhance blood flow to the kidneys and placenta, and offer a simple, low-cost approach worth investigating further.

Can Beetroot Juice Improve Pregnancy Outcomes in Women With Chronic Kidney Disease?

To explore whether a simple dietary intervention could support pregnant women with chronic kidney disease (CKD), researchers from King’s College London conducted the ORCHARD-BEET trial.

The multicenter randomized feasibility study enrolled 108 pregnant women with stage G2–G5 CKD from eight UK hospitals before 25 weeks of pregnancy.

Participants received either standard pregnancy care or daily nitrate-rich beetroot juice (400 mg dietary nitrate).

While the primary aim was to assess whether a larger clinical trial would be feasible, the study also reported several encouraging maternal and neonatal outcomes.

However, the authors emphasize that larger randomized trials are still needed to confirm these findings before beetroot juice can be recommended as routine care.

Key Findings from the ORCHARD-BEET Trial

Why Does Chronic Kidney Disease Make Pregnancy More Challenging?

Pregnancy naturally increases blood volume and places extra demands on the kidneys as they work to support both the mother and the developing baby. For women with chronic kidney disease (CKD), this additional strain can increase the risk of complications throughout pregnancy.

Approximately 3% of pregnancies occur in women with CKD, and these pregnancies require specialist monitoring because of their higher risk profile (2^✔ ✔Trusted Source
Clinical practice guideline on pregnancy and renal disease

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Women with CKD are at increased risk of:

• Preeclampsia
• Worsening kidney function
• Preterm birth
• Fetal growth restriction
• Low birth weight
• Neonatal intensive care admission

Managing CKD during pregnancy is equally challenging because:

• Pregnancy places extra workload on the kidneys, which may accelerate kidney function decline.
• Several commonly prescribed kidney medications, particularly those acting on the renin-angiotensin system, cannot be used safely during pregnancy because of potential risks to the developing baby.
• Women have limited treatment options to protect kidney function during pregnancy.
• Few interventions have been proven to safely preserve kidney health while ensuring the well-being of both mother and baby.

These challenges have prompted researchers to explore simple nutritional approaches, such as dietary nitrate from beetroot juice, that may help support kidney health without exposing the fetus to unnecessary medication risks.

How Could Beetroot Juice Help Protect the Kidneys During Pregnancy?

The potential benefits of beetroot juice come from its naturally high dietary nitrate content rather than the beetroot itself.

Vegetables such as beetroot, spinach, lettuce, and arugula are among the richest natural sources of dietary nitrate (3^✔ ✔Trusted Source
Nitrate and Nitrite in the Diet: Protective and Harmful Effects in Health and Disease

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Once consumed, nitrate is converted through the nitrate–nitrite–nitric oxide pathway, increasing the body’s production of nitric oxide (NO), an important signalling molecule that helps relax blood vessels and improve circulation.

A review published in Vascular Pharmacology explains that nitric oxide plays a central role in healthy pregnancy. It helps (4^✔ ✔Trusted Source
Nitric oxide and the biology of pregnancy

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• Relax and widen blood vessels.
• Improve blood flow to the kidneys and placenta.
• Support placental development and fetal growth.
• Maintain healthy maternal cardiovascular adaptations.
• Regulate placental circulation throughout pregnancy.

The review also notes that reduced nitric oxide availability has been linked to pregnancy complications such as hypertensive disorders, preeclampsia, and fetal growth restriction, making strategies that improve nitric oxide signalling an active area of research.

This biological mechanism provided the rationale for the ORCHARD-BEET trial. By increasing dietary nitrate intake through beetroot juice, researchers hoped to improve nitric oxide production naturally, reducing stress on the kidneys while supporting healthier blood flow during pregnancy.

Should Pregnant Women with CKD Start Drinking Beetroot Juice Now?

The findings are encouraging, but the answer is not yet.

Researchers describe beetroot juice as a promising, low-cost, food-based intervention that could help support kidney health during pregnancy.

However, the study was designed as a feasibility trial, meaning its primary goal was to determine whether a larger randomized clinical trial could be conducted successfully rather than to provide definitive proof of effectiveness.

Experts therefore recommend caution because:

• The study involved a relatively small number of participants.
• Benefits such as improved kidney function and fewer neonatal admissions were encouraging trends rather than definitive outcomes.
• Larger, adequately powered clinical trials are still needed before routine recommendations can be made.
• Women with CKD require individualized dietary advice based on their kidney function, blood pressure, potassium levels, and medications.

For these reasons, pregnant women with chronic kidney disease should not begin beetroot juice supplementation without discussing it with their nephrologist and obstetrician.

References:

1. Randomized Trial of Dietary Nitrate Supplementation in CKD Pregnancy (ORCHARD-BEET) – (https://www.sciencedirect.com/science/article/pii/S2468024926029360)
2. Clinical practice guideline on pregnancy and renal disease – (https://link.springer.com/article/10.1186/s12882-019-1560-2)
3. Nitrate and Nitrite in the Diet: Protective and Harmful Effects in Health and Disease – (https://link.springer.com/article/10.1007/s13668-025-00678-5)
4. Nitric oxide and the biology of pregnancy – (https://www.sciencedirect.com/science/article/abs/pii/S1537189118302763)

Source-Medindia