Department of Internal Medicine, School of Medicine, Pontificia Universidade Católica do Paraná, Curitiba, Brazil.
Division of Nephrology, Pro-Rim Foundation, Joinville, Brazil.
Blood Purif. 2018;45(1-3):166-172. doi: 10.1159/000485154. Epub 2018 Jan 26.
Hypertension affects almost all chronic kidney disease patients and is related to poor outcomes. Sodium intake is closely related to blood pressure (BP) levels in this population and decreasing its intake consistently improves the BP control particularly in short-term controlled trials. However, most patients struggle in following a controlled diet on sodium according to the guidelines recommendation due to several factors and barriers discussed in this article.
This review article summarizes the current knowledge related to the associations between sodium consumption, BP, and the risk of cardiovascular disease and chronic kidney disease (CKD); it also provides recommendations of how to achieve sodium intake lowering. Key Messages: Evidences support the benefits in decreasing sodium intake on markers of cardiovascular and renal outcomes in CKD. Trials had shorter follow-up and to maintain long-term sodium intake control is a major challenge. Larger studies with longer follow-up looking at hard endpoints will be important to drive future recommendations.
高血压几乎影响所有慢性肾病患者，与不良预后相关。该人群的钠摄入量与血压水平密切相关，持续减少钠的摄入量可显著改善血压控制，特别是在短期对照试验中。然而，由于本文讨论的多种因素和障碍，大多数患者在遵循指南推荐的钠饮食控制方面存在困难。
本文综述了钠摄入、血压和心血管疾病及慢性肾脏病（CKD）风险之间的关联的最新知识；还提供了如何实现降低钠摄入的建议。
有证据表明，减少 CKD 患者的钠摄入量对心血管和肾脏结局标志物有益。试验随访时间较短，长期控制钠摄入量是一个主要挑战。开展随访时间更长、着眼于硬终点的大型研究将对制定未来建议很重要。
