A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients

Katrina L Campbell; David W Johnson; Judith D Bauer; Carmel M Hawley; Nicole M Isbel; Michael Stowasser; Jonathan P Whitehead; Goce Dimeski; Emma McMahon

doi:10.1186/1471-2369-15-57

A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients

Katrina L Campbell
, David W Johnson
, Judith D Bauer
, Carmel M Hawley
, Nicole M Isbel
, Michael Stowasser
, Jonathan P Whitehead
, Goce Dimeski
, Emma McMahon

Research output: Contribution to journal › Article › Research › peer-review

50 Citations (Scopus)

Abstract

BACKGROUND: Dietary sodium restriction is a key management strategy in chronic kidney disease (CKD). Recent evidence has demonstrated short-term reduction in blood pressure (BP) and proteinuria with sodium restriction, however the effect on other cardiovascular-related risk factors requires investigation in CKD.

METHODS: The LowSALT CKD study involved 20 hypertensive Stage III-IV CKD patients counselled by a dietitian to consume a low-sodium diet (<100 mmol/day). The study was a randomised crossover trial comparing 2 weeks of high-sodium (additional 120 mmol sodium tablets) and low-sodium intake (placebo). Measurements were taken after each crossover arm including BP (peripheral and central), adipokines (inflammation markers and adiponectin), volume markers (extracellular-to-intracellular [E/I] fluid ratio; N-terminal pro-brain natriuretic peptide [NT-proBNP]), kidney function (estimated Glomerular Filtration Rate [eGFR]) and proteinuria (urine protein-creatinine ratio [PCR] and albumin-creatinine ratio [ACR]). Outcomes were compared using paired t-test for each cross-over arm.

RESULTS: BP-lowering benefits of a low-sodium intake (peripheral BP (mean ± SD) 148/82 ± 21/12 mmHg) from high-sodium (159/87 ± 15/10 mmHg) intake were reflected in central BP and a reduction in eGFR, PCR, ACR, NTproBNP and E/I ratio. There was no change in inflammatory markers, total or high molecular weight adiponectin.

CONCLUSIONS: Short-term benefits of sodium restriction on BP were reflected in significant change in kidney function and fluid volume parameters. Larger, long-term adequately powered trials in CKD are necessary to confirm these results.

TRIAL REGISTRATION: Universal Trial Number U1111-1125-2149 registered on 13/10/2011; Australian New Zealand Clinical Trials Registry Number ACTRN12611001097932 registered on 21/10/2011.

Original language	English
Pages (from-to)	57
Journal	BMC Nephrology
Volume	15
DOIs	https://doi.org/10.1186/1471-2369-15-57
Publication status	Published - 4 Apr 2014
Externally published	Yes

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1 Active

Nutrition for Chronic Disease and Disability: Research to improve health related quality of life and bring forward the under-represented voice
Reidlinger, D. (Project Lead), Davidson, A. (HDR Student), Campbell, K. (Associate Investigator), Kelly, J. (Associate Investigator), Mayr, H. (Chief Investigator), English, C. (HDR Student), Mueller, K. (Chief Investigator), MacKenzie-Shalders, K. (Assistant Professor), Van der Meij, B. (Research Fellow), Crichton, M. (HDR Student), Marshall, S. (Research Fellow), Turner, C. (Assistant Professor), Marx, W. (Associate Investigator), Utter, J. (Associate Professor), Maugeri, B. (Assistant Professor) & Tang, X. (Admin)
1/01/14 → 31/08/30
Project: Research

Cite this

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title = "A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients",

abstract = "BACKGROUND: Dietary sodium restriction is a key management strategy in chronic kidney disease (CKD). Recent evidence has demonstrated short-term reduction in blood pressure (BP) and proteinuria with sodium restriction, however the effect on other cardiovascular-related risk factors requires investigation in CKD.METHODS: The LowSALT CKD study involved 20 hypertensive Stage III-IV CKD patients counselled by a dietitian to consume a low-sodium diet (<100 mmol/day). The study was a randomised crossover trial comparing 2 weeks of high-sodium (additional 120 mmol sodium tablets) and low-sodium intake (placebo). Measurements were taken after each crossover arm including BP (peripheral and central), adipokines (inflammation markers and adiponectin), volume markers (extracellular-to-intracellular [E/I] fluid ratio; N-terminal pro-brain natriuretic peptide [NT-proBNP]), kidney function (estimated Glomerular Filtration Rate [eGFR]) and proteinuria (urine protein-creatinine ratio [PCR] and albumin-creatinine ratio [ACR]). Outcomes were compared using paired t-test for each cross-over arm.RESULTS: BP-lowering benefits of a low-sodium intake (peripheral BP (mean ± SD) 148/82 ± 21/12 mmHg) from high-sodium (159/87 ± 15/10 mmHg) intake were reflected in central BP and a reduction in eGFR, PCR, ACR, NTproBNP and E/I ratio. There was no change in inflammatory markers, total or high molecular weight adiponectin.CONCLUSIONS: Short-term benefits of sodium restriction on BP were reflected in significant change in kidney function and fluid volume parameters. Larger, long-term adequately powered trials in CKD are necessary to confirm these results.TRIAL REGISTRATION: Universal Trial Number U1111-1125-2149 registered on 13/10/2011; Australian New Zealand Clinical Trials Registry Number ACTRN12611001097932 registered on 21/10/2011.",

author = "Campbell, \{Katrina L\} and Johnson, \{David W\} and Bauer, \{Judith D\} and Hawley, \{Carmel M\} and Isbel, \{Nicole M\} and Michael Stowasser and Whitehead, \{Jonathan P\} and Goce Dimeski and Emma McMahon",

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doi = "10.1186/1471-2369-15-57",

language = "English",

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pages = "57",

journal = "BMC Nephrology",

issn = "1471-2369",

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TY - JOUR

T1 - A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients

AU - Campbell, Katrina L

AU - Johnson, David W

AU - Bauer, Judith D

AU - Hawley, Carmel M

AU - Isbel, Nicole M

AU - Stowasser, Michael

AU - Whitehead, Jonathan P

AU - Dimeski, Goce

AU - McMahon, Emma

PY - 2014/4/4

Y1 - 2014/4/4

N2 - BACKGROUND: Dietary sodium restriction is a key management strategy in chronic kidney disease (CKD). Recent evidence has demonstrated short-term reduction in blood pressure (BP) and proteinuria with sodium restriction, however the effect on other cardiovascular-related risk factors requires investigation in CKD.METHODS: The LowSALT CKD study involved 20 hypertensive Stage III-IV CKD patients counselled by a dietitian to consume a low-sodium diet (<100 mmol/day). The study was a randomised crossover trial comparing 2 weeks of high-sodium (additional 120 mmol sodium tablets) and low-sodium intake (placebo). Measurements were taken after each crossover arm including BP (peripheral and central), adipokines (inflammation markers and adiponectin), volume markers (extracellular-to-intracellular [E/I] fluid ratio; N-terminal pro-brain natriuretic peptide [NT-proBNP]), kidney function (estimated Glomerular Filtration Rate [eGFR]) and proteinuria (urine protein-creatinine ratio [PCR] and albumin-creatinine ratio [ACR]). Outcomes were compared using paired t-test for each cross-over arm.RESULTS: BP-lowering benefits of a low-sodium intake (peripheral BP (mean ± SD) 148/82 ± 21/12 mmHg) from high-sodium (159/87 ± 15/10 mmHg) intake were reflected in central BP and a reduction in eGFR, PCR, ACR, NTproBNP and E/I ratio. There was no change in inflammatory markers, total or high molecular weight adiponectin.CONCLUSIONS: Short-term benefits of sodium restriction on BP were reflected in significant change in kidney function and fluid volume parameters. Larger, long-term adequately powered trials in CKD are necessary to confirm these results.TRIAL REGISTRATION: Universal Trial Number U1111-1125-2149 registered on 13/10/2011; Australian New Zealand Clinical Trials Registry Number ACTRN12611001097932 registered on 21/10/2011.

AB - BACKGROUND: Dietary sodium restriction is a key management strategy in chronic kidney disease (CKD). Recent evidence has demonstrated short-term reduction in blood pressure (BP) and proteinuria with sodium restriction, however the effect on other cardiovascular-related risk factors requires investigation in CKD.METHODS: The LowSALT CKD study involved 20 hypertensive Stage III-IV CKD patients counselled by a dietitian to consume a low-sodium diet (<100 mmol/day). The study was a randomised crossover trial comparing 2 weeks of high-sodium (additional 120 mmol sodium tablets) and low-sodium intake (placebo). Measurements were taken after each crossover arm including BP (peripheral and central), adipokines (inflammation markers and adiponectin), volume markers (extracellular-to-intracellular [E/I] fluid ratio; N-terminal pro-brain natriuretic peptide [NT-proBNP]), kidney function (estimated Glomerular Filtration Rate [eGFR]) and proteinuria (urine protein-creatinine ratio [PCR] and albumin-creatinine ratio [ACR]). Outcomes were compared using paired t-test for each cross-over arm.RESULTS: BP-lowering benefits of a low-sodium intake (peripheral BP (mean ± SD) 148/82 ± 21/12 mmHg) from high-sodium (159/87 ± 15/10 mmHg) intake were reflected in central BP and a reduction in eGFR, PCR, ACR, NTproBNP and E/I ratio. There was no change in inflammatory markers, total or high molecular weight adiponectin.CONCLUSIONS: Short-term benefits of sodium restriction on BP were reflected in significant change in kidney function and fluid volume parameters. Larger, long-term adequately powered trials in CKD are necessary to confirm these results.TRIAL REGISTRATION: Universal Trial Number U1111-1125-2149 registered on 13/10/2011; Australian New Zealand Clinical Trials Registry Number ACTRN12611001097932 registered on 21/10/2011.

U2 - 10.1186/1471-2369-15-57

DO - 10.1186/1471-2369-15-57

M3 - Article

C2 - 24708818

SN - 1471-2369

VL - 15

SP - 57

JO - BMC Nephrology

JF - BMC Nephrology

ER -

A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients

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Nutrition for Chronic Disease and Disability: Research to improve health related quality of life and bring forward the under-represented voice

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