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Cited by 161Sodium Intake and HealthBlood Pressure and Hypertension StudiesChronic Kidney Disease and Diabetes

Dietary Salt Restriction in Chronic Kidney Disease: A Meta-Analysis of Randomized Clinical Trials

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Garofalo, Carlo, Borrelli, Silvio, Provenzano, Michele, De Stefano, Toni, Vita, Carlo, Chiodini, Paolo, Minutolo, Roberto, Nicola, Luca De +1 more·2018·Nutrients
DOI 10.3390/nu10060732PMC PMC6024651
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Abstract

Background. A clear evidence on the benefits of reducing salt in people with chronic kidney disease (CKD) is still lacking. Salt restriction in CKD may allow better control of blood pressure (BP) as shown in a previous systematic review while the effect on proteinuria reduction remains poorly investigated. Methods. We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the effects of low versus high salt intake in adult patients with non-dialysis CKD on change in BP, proteinuria and albuminuria. Results. Eleven RCTs were selected and included information about 738 CKD patients (Stage 1–4); urinary sodium excretion was 104 mEq/day (95%CI, 76–131) and 179 mEq/day (95%CI, 165–193) in low- and high-sodium intake subgroups, respectively, with a mean difference of −80 mEq/day (95%CI from −107 to −53; p <0.001). Overall, mean differences in clinic and ambulatory systolic BP were −4.9 mmHg (95%CI from −6.8 to −3.1, p <0.001) and −5.9 mmHg (95%CI from −9.5 to −2.3, p <0.001), respectively, while clinic and ambulatory diastolic BP were −2.3 mmHg (95%CI from −3.5 to −1.2, p <0.001) and −3.0 mmHg (95%CI from −4.3 to −1.7; p <0.001), respectively. Mean differences in proteinuria and albuminuria were −0.39 g/day (95%CI from −0.55 to −0.22, p <0.001) and −0.05 g/day (95%CI from −0.09 to −0.01, p = 0.013). Conclusion. Moderate salt restriction significantly reduces BP and proteinuria/albuminuria in patients with CKD (Stage 1–4).

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  • A Cochrane Review of eight RCTs (N=3518) concluded that there is insufficient power to confirm clinically important effects of dietary advice and salt substitution on cardiovascular mortality in normotensive or hypertensive populations.

    “Review of eight RCTs (N=3518) concluded that there is insufficient power to confirm clinically”

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Authors
Garofalo, C., Borrelli, S., Provenzano, M., De Stefano, T., Vita, C., Chiodini, P., Minutolo, R., Nicola, L. D., & Conte, G.
Affiliations
  • University of Campania "Luigi Vanvitelli" (IT)
  • Division of Nephrology, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Corresponding author
Conte, Giuseppe
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2018-06-06
Volume
10
Issue
6
Pages
732
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu10060732
PMC
PMC6024651
OpenAlex
W2806758694
Cited by
161
References
3
Citations by year
2026: 10 · 2025: 19 · 2024: 17 · 2023: 17 · 2022: 25 · 2021: 27 · 2020: 31 · 2019: 14 · 2016: 1
FWCI
2.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
dietary salt restriction, chronic kidney disease, blood pressure, proteinuria, albuminuria, sodium excretion, predialysis, sodium restriction
MeSH terms
Adult, Aged, Albuminuria, Blood Pressure, Diet, Sodium-Restricted, Female, Humans, Kidney, Male, Middle Aged, Randomized Controlled Trials as Topic, Treatment Outcome, Sodium Chloride, Dietary, Evidence-Based Medicine, Renal Insufficiency, Chronic

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