• Assessment
    What are the associations between renin or aldosterone levels and health outcomes in CHF patients?
    • Conclusion

      Limited evidence indicates that aldosterone levels, plasma renin activity and hospital re-admissions decrease in compensated CHF patients on a dietary sodium intake of approximately 2,760mg per day (120mmol per day), relative to a sodium intake of 1,840mg per day (80mmol per day). The risk of mortality, however, while lower in the higher intake group, did not differ significantly between sodium intake groups.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Intervention
    What is the effect of dietary sodium intake on renal function in patients with congestive heart failure?
    • Conclusion

      There is limited evidence that significant reductions in sodium intake in someone with CHF may decrease glomerular filtration rate. From the studies analyzed, it is not known whether the change is either harmful or irreversible.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the effect of dietary sodium on renin and aldosterone in patients with congestive heart failure?
    • Conclusion

      There is limited evidence that an individual with CHF will have an increased plasma renin activity level (PRAL) and aldosterone production rate at lower sodium intakes. The level of sodium intake that is associated with increases in plasma renin activity and aldosterone production rate is not known from the studies analyzed. 

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the effect of sodium intake on health outcomes in CHF patients?
    • Conclusion

      Limited evidence suggests that a moderate dietary intake of about 2,760mg to 3,000mg per day decreases hospital re-admissions and mortality in patients with compensated CHF when compared to higher or lower intakes. However, it is not clear from the studies analyzed at what level a lower sodium intake would have an unfavorable effect on health outcomes in CHF patients.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.