Renal function in relation to sodium intake: a quantitative review of the literature.
We undertook a quantitative literature review to search for evidence underpinning current guidelines proposing a reduction of sodium intake to less than 2.4 g/d for the management of chronic kidney disease. We searched PubMed for peer-reviewed articles published from January 1980 through May 2016. Two investigators screened 5072 publications and extracted data from 36, including 11 cross-sectional and 5 longitudinal observational studies and 20 intervention trials. Within-study effect sizes were pooled and standardized to a sodium gradient of 100 mmol/d by using inverse-variance weighted random effects models. Among cross-sectional studies, the pooled odds ratio for albuminuria was 1.23 (95% confidence interval [CI], 0.92-1.64, P = 0.16), and the pooled mean difference in glomerular filtration rate amounted to 8.5 ml/min (CI, -2.3 to 19.2 ml/min; P = 0.12). In the cohort studies, the pooled relative risk of a renal endpoint was 1.08 (CI, 0.92-1.29; P = 0.35). In the intervention trials (median duration, 14 days [range, 4-186 days]), the mean differences in estimated glomerular filtration rate and albuminuria (high vs. low sodium intake) averaged 4.6 ml/min (CI, 3.4-5.8 ml/min; P < 0.0001) and 53% (CI, 21-84; P = 0.001), respectively. Cochran's Q statistic indicated significant heterogeneity among cross-sectional studies for both estimated glomerular filtration rate and albuminuria (P < 0.0001) and among intervention trials for albuminuria (P = 0.04). In conclusion, there is no robust evidence suggesting that long-term reduction of salt intake would prevent chronic kidney disease or delay its progression. However, our current findings, which were mainly obtained in people with slight renal impairment, cannot be extrapolated to patients with moderate or severe chronic kidney disease.
['Nomura|Kyoko|K|', 'Asayama|Kei|K|', 'Jacobs|Lotte|L|', 'Thijs|Lutgarde|L|', 'Staessen|Jan A|JA|']
D000293:Adolescent D000328:Adult D000368:Aged D000419:Albuminuria D004039:Diet, Sodium-Restricted D005260:Female D005919:Glomerular Filtration Rate D006801:Humans D007668:Kidney D008297:Male D008875:Middle Aged D011379:Prognosis D065840:Protective Factors D064167:Recommended Dietary Allowances D051436:Renal Insufficiency, Chronic D012307:Risk Factors D012982:Sodium, Dietary D055815:Young Adult
sodium albuminuria glomerular filtration rate salt CKD meta-analysis