Chronic Kidney Disease

CKD: Sodium (2018)

• Intervention
  What is the effect of dietary sodium intake and mortality in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD dialysis patients, one study reported that low dietary sodium intake was significantly associated with higher overall mortality (1-6 years), while another study showed that higher dietary sodium (Na) intake was associated with greater adjusted mortality risk (2.1 years median).

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of dietary sodium intake and mortality in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dong J, Li Y, Yang Z, Luo J. Low dietary sodium intake increases the death risk in peritoneal dialysis. Clinical Journal of the American Society of Nephrology 2010; 5:240-7
      • Mc Causland F, Waikar S, Brunelli S. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients. Kidney International 2012; 82:204-11
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of urinary sodium excretion and mortality in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis patients, higher urinary sodium was associated with all-cause mortality in one study.

  • 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.
  • Evidence Summary: What is the effect of urinary sodium excretion and mortality in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • He J, Mills K, Appel L, Yang W, Chen J, Lee B, Rosas S, Porter A, Makos G, Weir M, Hamm L, Kusek J. Urinary Sodium and Potassium Excretion and CKD Progression. Journal of the American Society of Nephrology 2016; 27:1202-12
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of urinary sodium excretion on CKD progression in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis patients, higher urinary sodium excretion was associated with greater CKD progression (defined as incident end-stage renal disease (ESRD) or halving of eGFR from baseline) in one study.

  • 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.
  • Evidence Summary: What is the effect of urinary sodium excretion on CKD progression in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • He J, Mills K, Appel L, Yang W, Chen J, Lee B, Rosas S, Porter A, Makos G, Weir M, Hamm L, Kusek J. Urinary Sodium and Potassium Excretion and CKD Progression. Journal of the American Society of Nephrology 2016; 27:1202-12
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of urinary sodium excretion on composite CVD events in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis patients, higher urinary sodium excretion was associated with greater composite cardiovascular disease event in one study.

  • 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.
  • Evidence Summary: What is the effect of urinary sodium excretion on composite CVD events in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Mills K,Chen J,Yang W,Appel L,Kusek J,Alper A,Delafontaine P,Keane M,Mohler E,Ojo A,Rahman M,Ricardo A,Soliman E,Steigerwalt S,Townsend R,He J. Sodium Excretion and the Risk of Cardiovascular Disease in Patients With Chronic Kidney Disease. JAMA ; 315:2200-10
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on blood pressure in adults with CKD, Stages 1-5?

  • Conclusion

    In CKD pre-dialysis and dialysis patients, lower sodium intake significantly decreased blood pressure/mean arterial pressure in most studies.

  • 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.
  • Evidence Summary: What is the effect of sodium intake on blood pressure in adults with CKD 1-5D?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • de Brito-Ashurst I, Perry L, Sanders T, Thomas J, Dobbie H, Varagunam M, Yaqoob M. The role of salt intake and salt sensitivity in the management of hypertension in South Asian people with chronic kidney disease: a randomised controlled trial. Heart (British Cardiac Society) 2013; 99:1256-60
      • Fine A, Fontaine B, Ma M. Commonly prescribed salt intake in continuous ambulatory peritoneal dialysis patients is too restrictive: results of a double-blind crossover study. Journal of the American Society of Nephrology 1997; 8:1311-4
      • Konishi Y, Nishiyama A, Morikawa T, Kitabayashi C, Shibata M, Hamada M, Kishida M, Hitomi H, Kiyomoto H, Miyashita T, Mori N, Urushihara M, Kobori H, Imanishi M. Relationship between urinary angiotensinogen and salt sensitivity of blood pressure in patients with IgA nephropathy. Hypertension 2011; 58:205-11
      • Koomans H, Roos J, Dorhout Mees E, Delawi I. Sodium balance in renal failure. A comparison of patients with normal subjects under extremes of sodium intake. Hypertension 1985; 7:714-21
      • Liang X, Wang W, Li H. Water and sodium restriction on cardiovascular disease in young chronic hemodialysis patients. Chinese Medical Journal 2013; 126:1667-72
      • Magden K, Hur E, Yildiz G, Kose S, Bicak S, Yildirim I, Sayin M, Duman S. The effects of strict salt control on blood pressure and cardiac condition in end-stage renal disease: prospective-study. Renal Failure 2013; 35:1344-7
      • McMahon E, Bauer J, Hawley C, Isbel N, Stowasser M, Johnson D, Campbell K. A Randomized Trial of Dietary Sodium Restriction in CKD. Journal of the American Society of Nephrology 2013; 24:2096-2103
      • Slagman M, Waanders F, Hemmelder M, Woittiez A, Janssen W, Lambers Heerspink H, Navis G, Laverman G. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ (Clinical research ed.) 2011; 343:d4366
      • Rodrigues Telini L, de Carvalho Beduschi G, Caramori J, Castro J, Martin L, Barretti P. Effect of dietary sodium restriction on body water, blood pressure, and inflammation in hemodialysis patients: a prospective randomized controlled study. International Urology and Nephrology 2014; 46:91-7
      • Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of dietary sodium and hydrochlorothiazide on the antiproteinuric efficacy of losartan. Journal of the American Society of Nephrology 2008; 19:999-1007
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on blood pressure in adults with CKD, post-transplant?

  • Conclusion

    In post-transplantation patients, lower sodium intake significantly decreased blood pressure in one study.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on blood pressure in adults with CKD, post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Keven K, Yalcin S, Canbakan B, Kutlay S, Sengül S, Erturk S, Erbay B. The impact of daily sodium intake on posttransplant hypertension in kidney allograft recipients. Transplantation Proceedings 2006; 38:1323-6
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on eGFR in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis patients, lower sodium diet significantly reduced eGFR in one study but not in another study.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on eGFR in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Campbell K, Johnson D, Bauer J, Hawley C, Isbel N, Stowasser M, Whitehead J, Dimeski G, McMahon E. A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients. BMC Nephrology 2014; 15:57
      • de Brito-Ashurst I, Perry L, Sanders T, Thomas J, Dobbie H, Varagunam M, Yaqoob M. The role of salt intake and salt sensitivity in the management of hypertension in South Asian people with chronic kidney disease: a randomised controlled trial. Heart (British Cardiac Society) 2013; 99:1256-60
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on creatinine clearance in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis and dialysis patients, lower sodium intake decreased creatinine clearance in all studies.

  • 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.
  • Evidence Summary: What is the effect of sodium intake on creatinine clearance in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Konishi Y, Nishiyama A, Morikawa T, Kitabayashi C, Shibata M, Hamada M, Kishida M, Hitomi H, Kiyomoto H, Miyashita T, Mori N, Urushihara M, Kobori H, Imanishi M. Relationship between urinary angiotensinogen and salt sensitivity of blood pressure in patients with IgA nephropathy. Hypertension 2011; 58:205-11
      • Koomans H, Roos J, Dorhout Mees E, Delawi I. Sodium balance in renal failure. A comparison of patients with normal subjects under extremes of sodium intake. Hypertension 1985; 7:714-21
      • Slagman M, Waanders F, Hemmelder M, Woittiez A, Janssen W, Lambers Heerspink H, Navis G, Laverman G. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ (Clinical research ed.) 2011; 343:d4366
      • Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of dietary sodium and hydrochlorothiazide on the antiproteinuric efficacy of losartan. Journal of the American Society of Nephrology 2008; 19:999-1007
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on proteinuria, albuminuria, protein:creatinine (24 h urine), and albumin:creatinine (24 h urine) levels in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis patients, lower sodium intake decreased proteinuria, albuminuria, protein:creatinine (24 hour urine), and albumin:creatinine (24 hour urine) levels in all studies.

  • 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.
  • Evidence Summary: What is the effect of sodium intake on proteinuria, albuminuria, protein:creatinine (24 h urine), and albumin:creatinine (24 h urine) levels in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Campbell K, Johnson D, Bauer J, Hawley C, Isbel N, Stowasser M, Whitehead J, Dimeski G, McMahon E. A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients. BMC Nephrology 2014; 15:57
      • McMahon E, Bauer J, Hawley C, Isbel N, Stowasser M, Johnson D, Campbell K. A Randomized Trial of Dietary Sodium Restriction in CKD. Journal of the American Society of Nephrology 2013; 24:2096-2103
      • Slagman M, Waanders F, Hemmelder M, Woittiez A, Janssen W, Lambers Heerspink H, Navis G, Laverman G. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ (Clinical research ed.) 2011; 343:d4366
      • Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of dietary sodium and hydrochlorothiazide on the antiproteinuric efficacy of losartan. Journal of the American Society of Nephrology 2008; 19:999-1007
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on urinary sodium excretion in adults with CKD, pre-dialysis?

  • Conclusion

    In CKD pre-dialysis patients, lower salt diet significantly decreased sodium excretion in all studies.

  • 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.
  • Evidence Summary: What is the effect of sodium intake on urinary sodium excretion in adults with CKD, pre-dialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • de Brito-Ashurst I, Perry L, Sanders T, Thomas J, Dobbie H, Varagunam M, Yaqoob M. The role of salt intake and salt sensitivity in the management of hypertension in South Asian people with chronic kidney disease: a randomised controlled trial. Heart (British Cardiac Society) 2013; 99:1256-60
      • Kooman J, Deutz N, Zijlmans P, van den Wall Bake A, Gerlag P, van Hooff J , Leunissen K. The influence of bicarbonate supplementation on plasma levels of branched-chain amino acids in haemodialysis patients with metabolic acidosis. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 1997; 12:2397-401
      • McMahon E, Bauer J, Hawley C, Isbel N, Stowasser M, Johnson D, Campbell K. A Randomized Trial of Dietary Sodium Restriction in CKD. Journal of the American Society of Nephrology 2013; 24:2096-2103
      • Slagman M, Waanders F, Hemmelder M, Woittiez A, Janssen W, Lambers Heerspink H, Navis G, Laverman G. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ (Clinical research ed.) 2011; 343:d4366
      • Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of dietary sodium and hydrochlorothiazide on the antiproteinuric efficacy of losartan. Journal of the American Society of Nephrology 2008; 19:999-1007
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on urinary sodium excretion in adults with CKD, post-transplant?

  • Conclusion

    In CKD post-transplantation patients, lower salt diet significantly decreased sodium excretion.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on urinary sodium excretion in adults with CKD, post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Keven K, Yalcin S, Canbakan B, Kutlay S, Sengül S, Erturk S, Erbay B. The impact of daily sodium intake on posttransplant hypertension in kidney allograft recipients. Transplantation Proceedings 2006; 38:1323-6
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on fluid status in adults with CKD 1-5D and post-transplant?

  • Conclusion

    Two studies noted that lower dietary sodium intake significantly decreased extracellular volume in CKD pre-dialysis and dialysis patients but one study observed no significant changes in total body water and extracellular water in hemodialysis patents.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on fluid status in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Koomans H, Roos J, Dorhout Mees E, Delawi I. Sodium balance in renal failure. A comparison of patients with normal subjects under extremes of sodium intake. Hypertension 1985; 7:714-21
      • McMahon E, Bauer J, Hawley C, Isbel N, Stowasser M, Johnson D, Campbell K. A Randomized Trial of Dietary Sodium Restriction in CKD. Journal of the American Society of Nephrology 2013; 24:2096-2103
      • Rodrigues Telini L, de Carvalho Beduschi G, Caramori J, Castro J, Martin L, Barretti P. Effect of dietary sodium restriction on body water, blood pressure, and inflammation in hemodialysis patients: a prospective randomized controlled study. International Urology and Nephrology 2014; 46:91-7
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on weight in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD pre-dialysis and dialysis patients, lower dietary sodium intake decreased body weight in most studies but the pooled result was not significant.

  • 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.
  • Evidence Summary: What is the effect of sodium intake on weight in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Fine A, Fontaine B, Ma M. Commonly prescribed salt intake in continuous ambulatory peritoneal dialysis patients is too restrictive: results of a double-blind crossover study. Journal of the American Society of Nephrology 1997; 8:1311-4
      • Koomans H, Roos J, Dorhout Mees E, Delawi I. Sodium balance in renal failure. A comparison of patients with normal subjects under extremes of sodium intake. Hypertension 1985; 7:714-21
      • McMahon E, Bauer J, Hawley C, Isbel N, Stowasser M, Johnson D, Campbell K. A Randomized Trial of Dietary Sodium Restriction in CKD. Journal of the American Society of Nephrology 2013; 24:2096-2103
      • Slagman M, Waanders F, Hemmelder M, Woittiez A, Janssen W, Lambers Heerspink H, Navis G, Laverman G. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ (Clinical research ed.) 2011; 343:d4366
      • Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of dietary sodium and hydrochlorothiazide on the antiproteinuric efficacy of losartan. Journal of the American Society of Nephrology 2008; 19:999-1007
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on inter-dialytic weight gain in adults with CKD 1-5D and post-transplant?

  • Conclusion

    In CKD dialysis patients, one study noted a significant decrease with the sodium and fluid restriction group, another study reported a non-significant decrease in interdialytic weight gain/dry weight, and the last study did not observe any significant changes in sodium restriction group.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on inter-dialytic weight gain in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Liang X, Wang W, Li H. Water and sodium restriction on cardiovascular disease in young chronic hemodialysis patients. Chinese Medical Journal 2013; 126:1667-72
      • Magden K, Hur E, Yildiz G, Kose S, Bicak S, Yildirim I, Sayin M, Duman S. The effects of strict salt control on blood pressure and cardiac condition in end-stage renal disease: prospective-study. Renal Failure 2013; 35:1344-7
      • Rodrigues Telini L, de Carvalho Beduschi G, Caramori J, Castro J, Martin L, Barretti P. Effect of dietary sodium restriction on body water, blood pressure, and inflammation in hemodialysis patients: a prospective randomized controlled study. International Urology and Nephrology 2014; 46:91-7
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)
     
  What is the effect of sodium intake on inflammatory marker levels in adults with CKD 1-5D and post-transplant?

  • Conclusion

    Two studies did not show significant effects of low dietary sodium intake on inflammatory markers in CKD pre-dialysis and hemodialysis patients but one study noted reductions in inflammation markers among hemodialysis patients.

  • Grade: III
    • 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.
  • Evidence Summary: What is the effect of sodium intake on inflammatory marker levels in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Campbell K, Johnson D, Bauer J, Hawley C, Isbel N, Stowasser M, Whitehead J, Dimeski G, McMahon E. A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients. BMC Nephrology 2014; 15:57
      • Magden K, Hur E, Yildiz G, Kose S, Bicak S, Yildirim I, Sayin M, Duman S. The effects of strict salt control on blood pressure and cardiac condition in end-stage renal disease: prospective-study. Renal Failure 2013; 35:1344-7
      • Rodrigues Telini L, de Carvalho Beduschi G, Caramori J, Castro J, Martin L, Barretti P. Effect of dietary sodium restriction on body water, blood pressure, and inflammation in hemodialysis patients: a prospective randomized controlled study. International Urology and Nephrology 2014; 46:91-7
  • Search Plan and Results: CKD: Electrolytes: Sodium (2018)