Sodium

NA: Comparison of Grim Protocol to Modified Grim Protocol (2009)

Grim Protocol (Grim et al 1797)	Modified Grim Protocol (Strazzullo et al 2000)
Day 1 Admission Urine collected No Changes to usual diet	Day 1 Admission Dietary Na 50 mmol/d 10 Slow-Na tablets to achieve total Na intake of 150 mmol/d
Day 2 Arterlogram No changes to usual diet	Day 2 Saline Infusion 150 mmol/d (diet + tablets) 4 hour IV of 2 L isotonic (9.9%) saline (500 ml/hr)
Day 3 Saline Infusion 4 hour IV of 2 L isotonic (0.9%) salline (500 ml/hr) Urine Collected Thereafter, subject received a 150 mEq Na, 70 mEq K/d diet) (TOTAL Na "intake" for this day was 458 mEq	Day 3 Sodium and Volume Depletion Dietary Na 50 mmol/d Water limited to 25 ml Hx0 per kg body weight Frusemide (37.5 mg) given 3 times
Day 4 Furosemide Dietary Na limited to 10 mEq; K was 70mEq Water limited to 25 ml H2O per kg body weight Furosemide (40 mg) given three times	Day 4 Dietary Na 50 mmol/d Measurements
Day 5 Post-sodium Depletion Measurements	N/A

Reference:

Grim CE, Luft FC, Miller JZ, Brown PL, Gannon MA, Weinberger MH. Effects of sodium loading and depletion in normotensive first-degree relatives of essential hypertensives. J Lab Clin Med. 1979 Nov;94(5):764-71.

Strazzullo P, Galletti F, Dessi-Fulgheri P, Ferri C, Glorioso N, Malatino L, Mantero F, Manunta P, Semplicini A, Ghiadoni L, Zoccali, C. Prediction and consistency of blood pressure salt-sensitivity as assessed by a rapid volume expansion and contraction protocol. Journal of Nephrology 2000 Jan-Feb;13(1):46-53.