Changes in Dietary Salt Intake in People with Chronic Kidney Disease
McMahon EJ, Campbell KL, Bauer JD, Mudge DW, Kelly JT Changes in dietary salt intake in people with chronic kidney disease. Cochrane Database of Systematic Reviews 2021, No. 6. Art. No.: CD010070. doi: 10.1002 /14651858.CD010070.pub3. Accessed July 5, 2021.
Description.
Dietary restriction of salt intake may reduce the incidence of heart disease and may slow the decline in renal function in patients with chronic kidney disease (CKD). Therefore, this study was conducted to evaluate the benefits and harms of dietary salt restriction for CKD patients.
As an evaluation, a randomized controlled trial comparing two or more levels of salt intake in adults with any stage of CKD was employed, and two authors independently assessed the eligibility of the study, performed a risk of bias assessment, and used GRADE to evaluate the reliability of the evidence.
As a result,
the duration of the included studies is too short (1-36 weeks) to determine the impact of salt restriction on endpoints such as death, cardiovascular events, and CKD progression. Therefore, blood pressure and other secondary risk factors were investigated.
We found that salt restriction with a mean of -73.51 mmol/day (95% CI -92.76 to -54.27), equivalent to 4.2 g or 1690 mg sodium/day, changed systolic/diastolic blood pressure by -6.91 / -3.91 mm Hg.
Albuminuria was reduced by 36% (95% CI 26 to 44), five of which were performed in people in the early stages of CKD. The results regarding weight and body fat are uncertain because the observed weight change (-1.32 kg, 95% CI -1.94 to -0.70; 12 studies, 759 participants) may be due to fluid volume, lean tissue.
Also, low salt intake may reduce extracellular fluid volume in the early stages of CKD. And the effect of decreased salt intake on decreased antihypertensive drug dosing is unknown. Data on other types of adverse events were sparse.
We found high certainty evidence that salt reduction lowers blood pressure in CKD patients and, in the short term, albuminuria in people with early CKD.
