High Salt Intake is Associated with Renal Involvement in Japanese Patients with Type 2 Diabetes Mellitus

Abstract

Objective The aim of our study was to investigate clinical and nutritional factors associated with renal involvement in patients with type 2 diabetes. Patients We performed a cross-sectional study of 71 patients with type 2 diabetes who were being educated at our hospital from September 2006 to February 2008. The patients were divided into two groups; Group I consisted of 40 patients with both an estimated glomerular filtration rate (eGFR) of ! 60 mL/min/1.73 m 2 and normoalbuminuria, and Group II consisted of 31 patients with either microalbuminuria/overt proteinuria or an eGFR of <60 mL/min/1.73 m 2 . We compared the age, body mass index (BMI), blood pressure, duration from onset of diabetes, use of hypoglycemic agents and insulin, biochemistry data, including HbA1c, pulse wave velocity corrected by blood pressure (PWVc) and the daily intake of several nutrients between the two groups. A multivariate logistic regression analysis was performed to identify factors independently associated with renal involvement. Results Group II had significantly higher values for BMI, the duration of diabetes, triglycerides, uric acid and PWVc than Group I. Group II tended to have a high salt intake compared to Group I. The multivariate logistic analysis revealed that the daily salt intake, PWVc and uric acid were independent factors associated with renal involvement (odds ratio, 1.15, 1.84 and 2.00; 95% confidence interval, 1.02-1.31, 1.04-3.27 and 1.04-3.85, respectively). Conclusion Our data suggest that a high salt intake, in addition to arteriosclerosis, is associated with renal involvement in our cohort with type 2 diabetes.

High‐Salt Enhances the Inflammatory Response by Retina Pigment Epithelium Cells following Lipopolysaccharide Stimulation

“…High-salt intake is recognized as an important global health issue, especially in view of the fact that many commercially available food items often contain more than 100 times higher salt in comparison to homemade food [ 28 – 30 ]. Epidemiological studies suggest that high-salt intake is associated with an increased risk of multiple sclerosis [ 31 ], chronic kidney disease [ 32 ], diabetes [ 33 ], and chronic heart failure [ 34 ]. Long term clinical intervention studies have not yet been reported but experimental animal models have shown that high-salt can aggravate the severity of EAE by inducing Th17 cells [ 19 , 20 , 24 ].…”

The twin white herrings: Salt and sugar

“…[ 59 ] The salt restriction improves glomerular hyperfiltration, kidney enlargement, and microalbuminuria in an experimental rat model of diabetes. [ 97 ] Restricting salt and water intake can effectively treat fluid overload in diabetic peritoneal dialysis patients, which may help reduce the use of hypertonic glucose solution. Avoid excessive salt consumption as a preventive measure for avoiding each type of renal calculus formation specially calcium oxalate stones.…”

Comparison of the effects of frequent versus conventional nutritional interventions in patients with type 2 diabetes mellitus: A randomized, controlled trial

“…Given this background, it is important to determine the risk factors for developing microalbuminuria and overt proteinuria in patients with diabetes in Japan. We previously analyzed the nutritional factors associated with the onset and progression of diabetic kidney disease (DKD) in a retrospective study of 71 patients with type 2 diabetes 8 . The results showed that obesity, dyslipidemia, hyperuricemia, arteriosclerosis and excessive salt intake were significantly associated with the onset and progression of type 2 diabetic nephropathy.…”