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Benefits of dietary sodium restriction in the management of chronic kidney disease.

Abstract

PURPOSE OF REVIEW

To evaluate the role of restricting dietary sodium intake in chronic kidney disease (CKD) and its complications.

RECENT FINDINGS

A consistent line of evidence shows that high dietary sodium intake is a determinant of therapy resistance to blockade of the renin-angiotensin-aldosterone system (RAAS). Addition of sodium restriction to RAAS blockade or to RAAS blockade combined with a diuretic permits a further reduction in urinary protein excretion of approximately 30%, which could be expected to reduce long-term renal risk by 25%.

SUMMARY

High sodium intake increases blood pressure and proteinuria, induces glomerular hyperfiltration and blunts the response to RAAS blockade. Although recommended in international guidelines, sodium restriction is not a spearhead in treating renal patients. Sodium status is only rarely mentioned in recent large intervention studies in CKD. Sodium intake in CKD is similar to that in the general population. Reduction of sodium intake to the target of 50-85 mmol/24 h in patients with CKD reduces blood pressure and proteinuria, the latter by approximately 30%, and should be actively pursued to improve outcome in CKD.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.

    ,

    Source

    MeSH

    Angiotensin II Type 1 Receptor Blockers
    Angiotensin-Converting Enzyme Inhibitors
    Blood Pressure
    Chronic Disease
    Combined Modality Therapy
    Diet, Sodium-Restricted
    Diuretics
    Drug Therapy, Combination
    Glomerular Filtration Rate
    Humans
    Kidney Diseases
    Proteinuria
    Renin-Angiotensin System
    Sodium Chloride, Dietary
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19713840

    Citation

    TY - JOUR T1 - Benefits of dietary sodium restriction in the management of chronic kidney disease. AU - Krikken,Jan A, AU - Laverman,Gozewijn D, AU - Navis,Gerjan, PY - 2009/8/29/entrez PY - 2009/8/29/pubmed PY - 2009/12/25/medline SP - 531 EP - 8 JF - Current opinion in nephrology and hypertension JO - Curr. Opin. Nephrol. Hypertens. VL - 18 IS - 6 N2 - PURPOSE OF REVIEW: To evaluate the role of restricting dietary sodium intake in chronic kidney disease (CKD) and its complications. RECENT FINDINGS: A consistent line of evidence shows that high dietary sodium intake is a determinant of therapy resistance to blockade of the renin-angiotensin-aldosterone system (RAAS). Addition of sodium restriction to RAAS blockade or to RAAS blockade combined with a diuretic permits a further reduction in urinary protein excretion of approximately 30%, which could be expected to reduce long-term renal risk by 25%. SUMMARY: High sodium intake increases blood pressure and proteinuria, induces glomerular hyperfiltration and blunts the response to RAAS blockade. Although recommended in international guidelines, sodium restriction is not a spearhead in treating renal patients. Sodium status is only rarely mentioned in recent large intervention studies in CKD. Sodium intake in CKD is similar to that in the general population. Reduction of sodium intake to the target of 50-85 mmol/24 h in patients with CKD reduces blood pressure and proteinuria, the latter by approximately 30%, and should be actively pursued to improve outcome in CKD. SN - 1473-6543 UR - https://www.unboundmedicine.com/medline/citation/19713840/full_citation L2 - http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1062-4821&volume=18&issue=6&spage=531 ER -