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Decreased dietary sodium intake may reduce albuminuria
An intervention that decreased dietary sodium intake lowered mean urinary albumin-to-creatinine ratio and reduced the risk of albuminuria, according to a published study.
“Although substantial advances in the treatment and prevention of [chronic kidney disease] CKD have been made with pharmaceutical interventions, there remains an unmet need for large scale, affordable and sustainable, nondrug approaches to the management of this disease,” Meg J. Jardine, PhD, of the George Institute for Global Health, University of New South Wales in Australia, and colleagues wrote. “Dietary sodium intake is an established cause of elevated blood pressure, and this observation provides strong rationale for evaluating the effects of sodium-reduction strategies on measures of kidney function. Several studies have suggested beneficial effects for sodium reduction on albuminuria, although these have been conducted in small, selected populations and are of short duration.”
To assess the impact of sustained dietary reduction of sodium on albuminuria, researchers conducted a secondary analysis of the China Rural Health Initiative Salt Reduction Study. The study included 119 villages in rural China consisting of 2,566 participants and 1,903 urine samples. Villages were randomized to either a sodium reduction program (education and access to reduced-sodium salt substitute) or control.
The primary outcome of the study was urinary albumin-to-creatinine ratio (uACR). Microalbuminuria (defined as uACR of 22.1 mg/g to 220.35 mg/g for men and 31 mg/g to 308.85 mg/g for women) and macroalbuminuria (defined as uACR as 220.35 mg/g or greater for men and 309.73 mg/g or greater for women) were also considered.
Urine samples at 24 hours showed dietary sodium intake was lower by a mean of 14 mmol/day in intervention participants vs. control participants and that, each day, the sodium reduction program reduced sodium intake by an equivalent of 0.82 grams.
At 18 months, the mean uACR was 8.85 mg/g for those in the intervention compared with 10.53 mg/g for control participants (15% difference). In addition, researchers found the risk for any albuminuria was reduced for those in the intervention group (odds ratio = 0.67).
“Whether the impact of dietary sodium reduction on albuminuria will translate into similar clinical benefits as those achieved through pharmaceutical measures remains unknown,” the researchers wrote. “The potential for both blood pressure-dependent and blood pressure-independent protection against adverse kidney outcomes suggests that salt reduction and salt substitute could produce large benefits, making a strong case for further trials examining effects on clinical renal outcomes. The widespread availability and low cost of dietary salt interventions mean that a positive result from such trials would have far-reaching implications for the global burden of kidney disease.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.