Physical activity and nutrition in chronic kidney disease.
Study Goal
The researchers aimed to evaluate the health benefits and risks of salt substitutes in chronic kidney disease (CKD) patients, focusing on blood pressure control and cardiovascular outcomes.
Results Summary
The study found that salt substitutes improved blood pressure control and reduced all-cause death and cardiovascular event risk in the general population compared to regular salt, but their safety in moderate to advanced CKD patients requires further investigation.
Population
General population and chronic kidney disease (CKD) patients.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
more physical activity | increase | health | chronic kidney disease | - | demonstrated health benefits | #1 |
a healthy dietary pattern rich in fruits and vegetables, whole grains, plant-based foods and low in salt, low in sugar, saturated fat, red meat and ultraprocessed foods | increase | health and kidney outcomes | chronic kidney disease population | - | supporting different health and kidney benefits | #2 |
a plant-based diet | increase | health and kidney outcomes | chronic kidney disease population | - | supporting different health and kidney benefits | #3 |
Mediterranean diet | increase | health and kidney outcomes | chronic kidney disease population | - | supporting different health and kidney benefits | #4 |
higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) | decrease | blood pressure | chronic kidney disease population | - | may be associated with lower | #5 |
higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) | increase | kidney outcomes | chronic kidney disease population | - | may be associated with better | #6 |
higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) | decrease | mortality | chronic kidney disease population | - | may be associated with lower | #7 |
salt substitutes | increase | blood pressure control | the general population | - | improved | #8 |
salt substitutes | decrease | all-cause death | the general population | - | reduced | #9 |
salt substitutes | decrease | cardiovascular event risk | the general population | - | reduced | #10 |
PURPOSE OF REVIEW: Lifestyle intervention is considered a cornerstone in chronic kidney disease management and has been recommended in different international or regional clinical practice guidelines in chronic kidney disease. However, evidence was largely based on the general population. Here we summarized the latest evidence supporting lifestyle intervention in chronic kidney disease. RECENT FINDINGS: Both observational cohort studies as well as randomized controlled trials have demonstrated health benefits with more physical activity in chronic kidney disease. There are compelling observational data supporting different health and kidney benefits with a healthy dietary pattern rich in fruits and vegetables, whole grains, plant-based foods and low in salt, low in sugar, saturated fat, red meat and ultraprocessed foods, a plant-based diet or Mediterranean diet in chronic kidney disease population. Clinical and epidemiologic studies also showed that higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) may be associated with lower blood pressure, better kidney outcomes and lower mortality in chronic kidney disease population. Randomized controlled trials also suggested that salt substitutes improved blood pressure control, reduced all-cause death and cardiovascular event risk in the general population compared with regular salt. SUMMARY: Accumulating evidence supports the current recommendation of encouraging physical activity and promoting a healthy dietary pattern in chronic kidney disease patients. Whether potassium needs restriction in chronic kidney disease diet requires further review. The safety versus benefits of salt substitutes in patients with moderate and advanced chronic kidney disease warrants further investigation.