Effects of Intensive Low-Salt Diet Education on Albuminuria among Nondiabetic Patients with Hypertension Treated with Olmesartan

Hwang, Jin Ho; Chin, Ho Jun; Kim, Sejoong; Kim, Yon Su; Park, Jung Hwan; Shin, Sung Joon; Lee, Sang Ho; Choi, Bum Soon; Lim, Chun Soo

doi:10.2215/cjn.01310214

Cited by 42 publications

(57 citation statements)

References 27 publications

(33 reference statements)

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“…One metaanalysis 13 and two RCTs were excluded because they included chronically ill populations: one involving patients with chronic disease (who also had hypertension) and one involving patients with chronic kidney disease (who were nondiabetic with hypertension). 14,15 Eight cohort studies did not investigate an outcome of interest for this review: one measured demographic determinants of subgroups with high sodium intake, 16 one measured adherence to recommendations, 17 one cohort study included unhealthy participants and did not investigate an outcome of interest, 18 and six studies included unhealthy populations including those with kidney disease, high cardiovascular disease risk, type 1 and 2 diabetes, and multiple sclerosis. [19][20][21][22][23][24] In addition, two RCTs were excluded: one was an implementation trial that did not investigate BP or a health outcome 25 and one study intervention was less than 4 weeks' duration.…”

Section: Resultsmentioning

confidence: 99%

The Science of Salt: A Systematic Review of Quality Clinical Salt Outcome Studies June 2014 to May 2015

Johnson

Thout

Trieu

et al. 2016

J of Clinical Hypertension

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) on the impact of dietary salt intake on clinical and population health are reviewed. Randomized controlled trials, cohort studies, and meta-analyses of these study types on the effect of sodium intake on blood pressure, or any substantive adverse health outcomes were identified from MEDLINE searches and quality indicators were used to select studies that were relevant to clinical and public health. From 6920 studies identified in the literature search, 144 studies were selected for review, of which only three In addition to the adverse effects of salt on BP and vascular risk, a range of other serious health problems are also implicated including gastric cancer and osteoporosis.3 On the basis of the evidence linking salt, BP, and vascular risk, the World Health Organization (WHO) recommends that all member states implement a salt reduction program. A 30% lowering in mean population salt intake by 2025 has been included as one of the targets of the "25 by 25" World Health Assembly/WHO initiative for the control of noncommunicable diseases.

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Section: Resultsmentioning

confidence: 99%

The Science of Salt: A Systematic Review of Quality Clinical Salt Outcome Studies June 2014 to May 2015

Johnson

Thout

Trieu

et al. 2016

J of Clinical Hypertension

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“…Also in combination with enalapril, it caused substantial improvement of the density of the microvascular net . Although not all agree, it appears that at the clinical level the importance of sodium intake is high, not only for hypertension‐mediated organ damage but also for the response to antihypertensive therapy.…”

Section: Effects Of Antihypertensive Treatment On Microvascular Dysfumentioning

confidence: 99%

Salt‐induced effects on microvascular function: A critical factor in hypertension mediated organ damage

Marketou

Maragkoudakis

Anastasiou

et al. 2019

J of Clinical Hypertension

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Salt has been linked very closely to the occurrence and complications of arterial hypertension. A large percentage of patients with essential hypertension are salt‐sensitive; that is, their blood pressure increases with increased salt intake and decreases with its reduction. For this reason, emphasis is placed on reducing salt intake to better regulate blood pressure. In day‐to‐day clinical practice this is viewed as mandatory for hypertensive patients who are judged to be salt‐sensitive. Previous studies have highlighted the negative effect of high‐salt diets on macrovascular function, which also affects blood pressure levels by increasing peripheral resistances. More recent studies provide a better overview of the pathophysiology of microvascular disorders and show that they are largely due to the overconsumption of salt. Microvascular lesions, which have a major impact on the functioning of vital organs, are often not well recognized in clinical practice and are not paid sufficient attention. In general, the damage caused by hypertension to the microvascular network is likely to be overlooked, while reversion of the damage is only rarely considered as a therapeutic target by the treating physician. The purpose of this review is to summarize the impact and the harmful consequences of increased salt consumption in the microvascular network, their significance and pathophysiology, and at the same time to place some emphasis on their treatment and reversion, mainly through diet.

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“…This is a subanalysis result of an open-label, case-controlled, randomized clinical trial exploring the proteinuria-lowering effects of a low salt diet in nondiabetic, hypertensive CKD patients taking RAS blockers [ 13 ]. All participants in the study were prescribed RAS blockers to control BP and reduce proteinuria and were educated about low-salt diet (LSD), although the intensity of education differed.…”

Section: Introductionmentioning

confidence: 99%

Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease

Ahn

Kim

Park

et al. 2018

Kidney Res Clin Pract.

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BackgroundWeight reduction is a lifestyle intervention that has been introduced for prevention and management of chronic kidney disease (CKD). We investigate the additive anti-proteinuric effect of weight reduction on the usage of angiotensin II receptor blockers (ARBs) and its potential mechanisms in hypertensive CKD patients.MethodsThis study is a subanalysis of data from an open-label, randomized, controlled clinical trial. Among the 235 participants, 227 were assigned to subgroups according to changes in body weight.ResultsFifty-eight participants (25.6%) were assigned to group 1 (≥1.5% decrease in body weight after 16 weeks), 32 participants (14.1%) were assigned to group 2 (1.5–0.1% decrease in body weight), and 136 participants (59.9%) were assigned to group 3 (≥ 0.0% increase in body weight). Characteristics at enrollment were not different among the three groups, but mean differences in weight and percent changes in urinary sodium excretion over the period were statistically different (P < 0.001 and P = 0.017). Over the study period, unintentional weight loss independently increased the probability of reduced albuminuria (group 1, relative risk 6.234, 95% confidence interval 1.913–20.315, P = 0.002). Among urinary cytokines, only podocalyxin level decreased significantly in participants who lost weight (P = 0.013).ConclusionWe observed that weight loss had an additive effect on the anti-proteinuric effects of ARBs in nondiabetic hypertensive CKD patients, although it was minimal. An additive effect was shown in both obese and non-obese participants, and its possible mechanism is related to reduction of podocyte damage.

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Effects of Intensive Low-Salt Diet Education on Albuminuria among Nondiabetic Patients with Hypertension Treated with Olmesartan

Cited by 42 publications

References 27 publications

The Science of Salt: A Systematic Review of Quality Clinical Salt Outcome Studies June 2014 to May 2015

The Science of Salt: A Systematic Review of Quality Clinical Salt Outcome Studies June 2014 to May 2015

Salt‐induced effects on microvascular function: A critical factor in hypertension mediated organ damage

Weight loss has an additive effect on the proteinuria reduction of angiotensin II receptor blockers in hypertensive patients with chronic kidney disease

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