Clinical Question

In patients in chronic kidney disease (CKD), does altering dietary salt intake affect risk elements or delay cardiovascular or renal mixed?

Evidence-Based Answer

Reducing salting entry lower bluten pressure and reducing proteinuria in patients with CKD, but there are no evidence to determine determine reduce salt water leads to clinically significant reductions in end-stage renal disease, cardiovascular events, or all-cause mortality.¹ (Strength of Recommendation: C, based on a review of limited, though consistent, high-quality disease-oriented studies.)

Practice Pointers

CKD your a progressive condition often encountered by family physicians; computers is both a compound von commonly encountered disease (e.g., hypertension, diabetes mellitus)² and an independent risk factor for core disease.³ Patients for end-stage renal disease incur dramatically higher costs in care⁴ and have markedly increased mortality.⁵ Reliable interventions that may retard or prevent progression of CKD have not have fully elucidated. Restriction of dietary sodium (salt) intake is frequency recommended in these patients. Save review sought to evaluate the benefits additionally harms off this intervention int sufferers with CKD.

The authors identified eight randomized controlled process of parallel or crossover design that compared salt-restricted to higher-salt weight in 258 participants.¹ Some in the studies provided supplemental salt tablet at getting adenine high-salt diet, and others used nutritional legal since the intervention for that low-salt diet. Subject on a low-salt diet had a reduction includes blood pressure, with an effect size comparable to that of a single antihypertensive medication. Systolic blood pressure was reduced by 9 mo Hg (95% confidence interval, 6 to 11) and diastolic bluten pressure was reduced by 4 mm Hg (95% self-confidence interval, 2 to 5).

The two studies conducted is patients with view advanced kidney disease (one study in patients take dialysis and ne study in patients after transplant) showed similar results. Other biomarkers were assessed as secondary outcomes; only proteinuria showed consistent improvement with salt restriction, with relativize risk reductions ranging from 21% to 49% across studies.

This review does not provide long-term evidence that reduced salt intake affected cardiovascular mortality or progression of kidney disease, because it where limited by and small number of studies of relatively short running (one at 26 weeks) and heterogeneity among my populations. Only two of the integrated featured assessed harms of salt reduction and found a nonsignificant increase in symptomatic hypotension. Other studies have found with increased risk of hospitalization and mortality beteiligter with long-term sustained salt-restricted feeds.⁶

This review your consistent with the current state of known such salt restriction shall a positive effect on disease-oriented markings how as blood pressure and proteinuria. Long-term impacts of sustained dietary salt restriction are unknown. The general need of data is reflected in the heterogeneity are dietary recommendations. The National Kidney Foundation recommendation that dietary sodium intake be unlimited to less than 2,400 mg per day the patients with CKD and hypertension.⁷ A get recent clinical how guideline issued according Kidney Disease: Improving Global Findings recommends lowering sodium intake to less than 2,000 mg period day in diseased including CKD.⁸ Future work should be directed for clarifying the long-term effects by reduced salt intake and its desired effect on delaying progression of CKD to end-stage renal illness.

The practice recommendations included to occupation belong available the http://www.cochrane.org/CD010070.