Long-Term Effects of Intensive Low-Salt Diet Education on Deterioration of Glomerular Filtration Rate among Non-Diabetic Hypertensive Patients with Chronic Kidney Disease.
Study Goal
The researchers aimed to determine whether an intensive low-salt diet education program could slow the decline of renal function in hypertensive patients with chronic kidney disease (CKD).
Results Summary
The study found that the intensive low-salt diet education program significantly slowed the rate of renal function decline compared to conventional education, with lower rates of serum creatinine increase and eGFR decline in the intensive group. The program was particularly effective in preserving eGFR in participants with specific risk factors like older age, obesity, and higher protein or salt intake.
Population
Hypertensive patients with chronic kidney disease (CKD).
Effective Dosage
Not specified
Duration
36 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
intensive low-salt diet education program | decrease | rate of renal function decline | hypertensive patients with CKD | - | attenuated | #1 |
conventional education | increase | rate of renal function decline | cohort participants | -1.53 ± 3.04 mL/min/1.73 m2/year | was significantly faster | #2 |
intensive low-salt diet education program | no change | percent of incremental change in serum creatinine ≥50% | intensive group | 1.1% | was | #3 |
conventional education | increase | percent of incremental change in serum creatinine ≥50% | conventional group | 8.2% | was | #4 |
intensive low-salt diet education program | no change | percent of decremental change in eGFR ≥30% | intensive group | 3.3% | was | #5 |
conventional education | increase | percent of decremental change in eGFR ≥30% | conventional group | 11.1% | was | #6 |
conventional education | increase | serum creatinine and eGFR | - | - | showed a higher risk for deterioration | #7 |
intensive education program | no change | eGFR | participants with one, several, or all of the following characteristics at the time of randomization: older age, female, obese, had higher protein intake, higher amounts of albuminuria, higher salt intake | - | preserved | #8 |
intensive low-salt diet education program | decrease | rate of renal function decline | hypertensive CKD patients | - | attenuated | #9 |
BACKGROUND: Diet modification, especially a decrease in salt intake, might be an important non-pharmacological strategy to improve chronic kidney disease (CKD) prognosis. OBJECTIVES: We conducted a prospective cohort study to investigate whether an intensive low-salt diet education program effectively attenuated the rate of renal function decline in hypertensive patients with CKD. METHODS: This cohort study recruited 171 participants from a previous open-labelled, case-controlled, randomized clinical trial that originally consisted of 245 hypertensive CKD patients who were assigned to two groups, intensive low-salt diet or conventional education. We evaluated the renal outcomes, which included the rate of change in estimated glomerular filtration rate (eGFR) per year, the increase in serum creatinine ≥50%, the decrease in eGFR ≥30%, and the percent change in albuminuria throughout the entire study period. RESULTS: The baseline characteristics of the cohort participants between the two groups were similar at the time of trial phase randomization. During the whole study period, the rate of renal function decline was significantly faster in the conventional group (0.11 ± 4.63 vs. -1.53 ± 3.04 mL/min/1.73 m2/year, p = 0.01). The percent of incremental change in serum creatinine ≥50% was 1.1% in the intensive group and 8.2% in the conventional group (p = 0.025), and the percent of decremental change in eGFR ≥30% was 3.3% in the intensive group and 11.1% in the conventional group (p= 0.048). With logistic regression analysis adjusted for related factors, we found that the conventional group showed a higher risk for deterioration in serum creatinine and eGFR during the entire study period. Especially, we found that the intensive education program preserved eGFR in participants with one, several, or all of the following characteristics at the time of randomization: older age, female, obese, had higher protein intake, higher amounts of albuminuria, higher salt intake. CONCLUSION: This cohort study demonstrated that an intensive low-salt diet education program attenuated the rate of renal function decline in hypertensive CKD patients independent of its effect on lowering salt intake or albuminuria during the 36 months of follow-up.