Title:Potential Novel Benefits of Sodium Restriction in Chronic Kidney Disease
Volume: 17
Issue: 1
Author(s): Rodolfo Valtuille*
Affiliation:
- Department of Clinical Research, Universidad Nacional Guillermo Brown, 2289 Espora Avenue, Burzaco, B1852FZD Buenos Aires,Argentina
Keywords:
Sodium, salt, chronic kidney disease, cardiovascular, blood pressure, fibroblast growth factor 23, metabolic acidosis,
gut microbiota.
Abstract: Chronic kidney disease is a global public health issue, and it has been considered as the
epidemic of the 21st century. Therefore, all initiatives addressed to slow down the evolution and
complications of this condition should be well received. While the effects of salt reduction on cardiovascular
disease have some controversial issues, in chronic kidney disease, such a policy is beneficial
in multiple aspects. In chronic kidney disease patients, dietary sodium restriction is regularly
recommended to control extracellular fluid expansion, hypertension and cardiovascular risk. Instead,
the effects of sodium reduction on chronic kidney disease progression are still controversial.
In the last years, potentially beneficial effects of a low sodium diet on chronic kidney disease evolution
have emerged. Firstly, recent magnetic resonance-based findings of increased Na depots in skin
and muscle associated with renal function, ageing and sodium intake open a vast body of investigation
as a potential tool for monitoring effects of sodium restriction. In this narrative review, we also
discussed novel aspects of sodium restriction in chronic kidney disease to manage metabolic acidosis
as well as renal effects on fibroblast growth factor 23 or gut microbiota. Beyond current evidence,
these approaches showed that common findings of kidney failure environment such as sodium
-sensitivity, micro-inflammation, arterial stiffness metabolic acidosis and sarcopenia could be
delayed controlling dietary sodium. Additional studies are now needed in populations with chronic
kidney disease to confirm these new findings, addressed to slow down the evolution and complications
of this condition.
