Effect of a Low Salt Diet on the Progression of Chronic Kidney Disease: A Prospective, Open-Label, Randomized Controlled Trial.

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241297766

Thananda Trakarnvanich, Worawon Chailimpamontree, Surasak Kantachuvesiri, Sirirat Anutrakulchai, Basmon Manomaipiboon, Tanun Ngamvitchukorn, Swangjit Suraamornkul, Thanphisit Trakarnvanich, Sathit Kurathong

{"title":"Effect of a Low Salt Diet on the Progression of Chronic Kidney Disease: A Prospective, Open-Label, Randomized Controlled Trial.","authors":"Thananda Trakarnvanich, Worawon Chailimpamontree, Surasak Kantachuvesiri, Sirirat Anutrakulchai, Basmon Manomaipiboon, Tanun Ngamvitchukorn, Swangjit Suraamornkul, Thanphisit Trakarnvanich, Sathit Kurathong","doi":"10.1177/21501319241297766","DOIUrl":null,"url":null,"abstract":"Introduction: A causal relationship exists between salt intake and hypertension, stroke, and kidney disease. However, whether or not reduced salt intake slows progression of renal diseases has been intensely debated.Methods: In this prospective, open-label, randomized controlled trial, we examined the impact of a low salt diet on renal function, blood pressure, and other metabolic parameters. Herein, 194 patients with chronic kidney disease (CKD) stages 1 to 3 were randomized in low salt (intervention) and control groups. The intervention group was provided a low salt diet (1.5 g/day) for 3 months. The control group consumed their usual diet, and daily food intake was recorded in the control group. Renal function tests, 24-h urinary sodium excretion, urinary protein, serum calcium, phosphorus, and electrolyte levels were recorded monthly.Results: After 3 months, the mean reduction in estimated glomerular filtration rate was significantly higher in the control group (mean reduction in eGFR, -3.011 mL/min/1.73 m2; 95% confidence interval (CI) = -5.367, -0.656, P = .013). Blood pressure (BP) decreased significantly in both groups; systolic and diastolic BP reduction at 3 months was significantly greater in the intervention group (systolic BP mean reduction -6.57/-4.29 mmHg; 95% CI = -10.24, -2.89) and diastolic BP mean reduction -6.95, -1.64 mmHg) compared with the control group (systolic BP mean reduction -0.58/-2.63 mmHg; 95%, CI = -4.33, 3.17 and diastolic BP mean reduction -5.34, -0.08 mmHg). The mean reduction in 24-h urine sodium excretion was greater in the intervention group, reaching a significant level at month 2 (-14.45 mmol/day; 95% CI = -27.63, -1.22).Conclusion: Overall, salt restriction can help slow the progression of renal insufficiency and results in statistically significant and clinically important reductions in BP among patients with CKD.Clinicaltrials.gov identifier: NCT05716386 on 28/01/2023.","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241297766"},"PeriodicalIF":3.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555744/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Primary Care and Community Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/21501319241297766","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: A causal relationship exists between salt intake and hypertension, stroke, and kidney disease. However, whether or not reduced salt intake slows progression of renal diseases has been intensely debated.

Methods: In this prospective, open-label, randomized controlled trial, we examined the impact of a low salt diet on renal function, blood pressure, and other metabolic parameters. Herein, 194 patients with chronic kidney disease (CKD) stages 1 to 3 were randomized in low salt (intervention) and control groups. The intervention group was provided a low salt diet (1.5 g/day) for 3 months. The control group consumed their usual diet, and daily food intake was recorded in the control group. Renal function tests, 24-h urinary sodium excretion, urinary protein, serum calcium, phosphorus, and electrolyte levels were recorded monthly.

Results: After 3 months, the mean reduction in estimated glomerular filtration rate was significantly higher in the control group (mean reduction in eGFR, -3.011 mL/min/1.73 m²; 95% confidence interval (CI) = -5.367, -0.656, P = .013). Blood pressure (BP) decreased significantly in both groups; systolic and diastolic BP reduction at 3 months was significantly greater in the intervention group (systolic BP mean reduction -6.57/-4.29 mmHg; 95% CI = -10.24, -2.89) and diastolic BP mean reduction -6.95, -1.64 mmHg) compared with the control group (systolic BP mean reduction -0.58/-2.63 mmHg; 95%, CI = -4.33, 3.17 and diastolic BP mean reduction -5.34, -0.08 mmHg). The mean reduction in 24-h urine sodium excretion was greater in the intervention group, reaching a significant level at month 2 (-14.45 mmol/day; 95% CI = -27.63, -1.22).

Conclusion: Overall, salt restriction can help slow the progression of renal insufficiency and results in statistically significant and clinically important reductions in BP among patients with CKD.

Clinicaltrials.gov identifier: NCT05716386 on 28/01/2023.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

低盐饮食对慢性肾病进展的影响：一项前瞻性、开放标签、随机对照试验。

介绍：盐摄入量与高血压、中风和肾脏疾病之间存在因果关系。然而，减少食盐摄入量是否能延缓肾脏疾病的进展一直存在激烈的争论：在这项前瞻性、开放标签、随机对照试验中，我们研究了低盐饮食对肾功能、血压和其他代谢指标的影响。在这项试验中，194 名慢性肾脏病（CKD）1 至 3 期患者被随机分为低盐组（干预组）和对照组。干预组接受为期 3 个月的低盐饮食（每天 1.5 克）。对照组则采用常规饮食，并记录对照组的每日食物摄入量。每月记录肾功能检查、24 小时尿钠排泄、尿蛋白、血清钙、磷和电解质水平：3 个月后，对照组估计肾小球滤过率的平均降幅明显高于对照组（eGFR 平均降幅为 -3.011 mL/min/1.73 m2; 95% 置信区间 (CI) = -5.367, -0.656, P = .013）。两组患者的血压（BP）均显著下降；干预组 3 个月时收缩压和舒张压的降幅明显更大（收缩压平均降幅 -6.57/-4.29 mmHg；95% CI = -10.24，-2.89）和舒张压平均降低-6.95，-1.64 mmHg）相比，干预组（收缩压平均降低-0.58/-2.63 mmHg；95%，CI = -4.33，3.17 和舒张压平均降低-5.34，-0.08 mmHg）明显高于对照组。干预组 24 小时尿钠排泄量的平均降幅更大，在第 2 个月达到显著水平（-14.45 毫摩尔/天；95% CI = -27.63, -1.22）：总体而言，限盐有助于延缓肾功能不全的进展，并能使慢性肾脏病患者的血压在统计学上显著降低，具有重要的临床意义：NCT05716386 on 28/01/2023。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊