Decreased dietary sodium tied to lower risk for albuminuria

  • Jardine MJ & al.
  • J Ren Nutr
  • 1 Jul 2019

  • International Clinical Digest
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Takeaway

  • Decreasing dietary sodium intake appears to reduce mean urinary albumin-to-creatinine ratio (uACR) and albuminuria risk.

Why this matters

  • Prior studies have been limited by small sample size and duration.
  • A salt reduction intervention could offer a cheaper alternative to pharmaceuticals for reducing albuminuria, with potential positive effects on renal and cardiovascular health.

Study design

  • Prespecified secondary analysis of the China Rural Health Initiative Salt Reduction Study (n=2566; mean age, 55 years) involving 119 villages randomly assigned to implementation of a community-based salt reduction program (education, salt substitute) or observation.
  • 1903 urine samples collected over 18 months.
  • Funding: NIH; CDC; United Health Group Chronic Disease Initiative; Kidney Health Australia.  

Key results

  • Urine samples at 24 hours showed that the multipronged intervention reduced dietary sodium intake by a mean of 14 mmol/day (P=.03) or about three-quarters of a gram of salt.
    • Urinary potassium excretion was 7 (95% CI, 4-10) mmol/day higher.
  • At 18 months, mean uACR was 15% lower with the intervention (8.85 vs 10.53 mg/g; P=.008), and risk for any albuminuria was 33% lower (OR, 0.67; 95% CI, 0.46-0.99).

Limitations

  • Benefit may be in part the result of higher potassium intake from the salt substitute.
  • Baseline measures not captured.

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