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

Jan A. Krikken, Gozewijn D. Laverman, Gerjan Navis*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

85 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)531-538
Number of pages8
JournalCURRENT OPINION IN NEPHROLOGY AND HYPERTENSION
Volume18
Issue number6
DOIs
Publication statusPublished - Nov-2009

Keywords

  • chronic kidney disease
  • dietary sodium intake
  • renin-angiotensin-aldosterone system blockade
  • ANGIOTENSIN-CONVERTING-ENZYME
  • BODY-MASS INDEX
  • STAGE RENAL-DISEASE
  • GLOMERULAR-FILTRATION-RATE
  • ADRIAMYCIN NEPHROTIC RATS
  • URINARY ALBUMIN EXCRETION
  • BLOOD-PRESSURE CONTROL
  • ACE-INHIBITION
  • ANTIPROTEINURIC EFFICACY
  • CARDIOVASCULAR RISK

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