INTRODUCTION: Modern acid-producing diets in patients with stage G3 to G5 chronic kidney disease (CKD) can cause severe acid accumulation with metabolic acidosis and less severe accumulation causing eubicarbonatemic acidosis in stages G2 to G3, each with kidney injury. The impact of these diets on acid accumulation in those with CKD but normal estimated glomerular filtration rate (eGFR) (CKD G1) is unclear. METHODS: We assessed whether acid accumulation occurs in patients with CKD and normal eGFR, and if added base-producing fruits and vegetables (F&Vs) or oral sodium bicarbonate (NaHCO RESULTS: Baseline acid accumulation, eGFR, urine excretion of albumin, N-acetyl-β-D-glucosamine, and angiotensinogen were not different among groups. Five-year acid accumulation (mean [SD]) was lower in F&V (-1.2 [11.0] mmol] and in HCO CONCLUSIONS: Dietary acid reduction reduces acid accumulation and kidney injury in patients with CKD and normal eGFR.