Abstract: FR-PO389

Long Term Effects of Intensive Low Salt Diet Education on Deterioration of Glomerular Filtration Rate among Non-Diabetic Hypertensive Patients with CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Lee, Anna, SNUBH, Gyeonggi-do, Korea (the Democratic People's Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
Background

We conducted a prospective cohort study to investigate whether lower dietary salt intake and the intensive low salt diet education are effective to reduce the rate of GFR decline among hypertensive CKD patients.

Methods

This study included 171 participants in the previous open-label, case-control, randomized clinical trial including 245 hypertensive CKD patients who took an olmesartan medoxomil until the end of the study and were assigned to receive an intensive low salt diet education or conventional education. We compared the eGFR change rate, the increase of serum creatinine ≥ 50%, the decrease of eGFR ≥ 30%, and the percent change of albuminuria during 36.3 ± 4.1 months after randomization between education groups.

Results

The mean differences of eGFR change rate between groups was 1.68 ml/min/1.73m2/year and 1.64 ml/min/1.73m2/year at 25.1 ± 4.0 months and at 36.3 ± 4.1 months after randomization, respectively. The percent of increment in serum creatinine ≥ 50% was 1.1 % in Intensive group and 8.2% in Control group (p=0.025), and the percent of decrease in eGFR ≥ 30% was 3.3 % in Intensive group and 11.1 % in Control group (p=0.048). Overall mean difference of 24-hour urine sodium excretion between groups were 10 mEq/day and did not show difference (p=0.430), however, in Control group, participants with higher urinary sodium excretion (≥200 mEq/day) showed rapid decline of eGFR (p=0.012) and participants with effective decrease of urinary sodium excretion during trial phase (decline≥ 25% of sodium excretion) showed more slow decline of eGFR (p=0.035).

Conclusion

This cohort study demonstrated intensive low salt diet education was independently related to slow eGFR decline during about 36 months follow-up period and higher salt intake resulted in more rapid decline of eGFR in participants with conventional low salt education.

Slope of eGFR(ml/min/1.73 m2/year) at each observation period compared to randomization period
Slope of eGFRIntensive groupControl GroupDifference of meanp-value
16-week-Randomization-12.72 ± 83.200.77 ± 74.17-0.160.269
1st cohort examination- Randomization0.23 ± 5.05-1.45 ± 4.951.680.031
2nd cohort examination- Randomization0.11 ± 4.62-1.53 ± 3.041.640.010

Funding

  • Veterans Affairs Support