Document Detail

Benefits of dietary sodium restriction in the management of chronic kidney disease.
MedLine Citation:
PMID:  19713840     Owner:  NLM     Status:  MEDLINE    
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.
Jan A Krikken; Gozewijn D Laverman; Gerjan Navis
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  18     ISSN:  1473-6543     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-15     Completed Date:  2009-12-24     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  531-8     Citation Subset:  IM    
Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.
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MeSH Terms
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Blood Pressure
Chronic Disease
Combined Modality Therapy
Diet, Sodium-Restricted*
Diuretics / therapeutic use
Drug Therapy, Combination
Glomerular Filtration Rate
Kidney Diseases / diet therapy*,  drug therapy,  etiology
Proteinuria / etiology,  prevention & control
Renin-Angiotensin System
Sodium Chloride, Dietary / adverse effects*
Treatment Outcome
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics; 0/Sodium Chloride, Dietary

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