scholarly journals Increased Sodium Intake Correlates With Greater Use of Antihypertensive Agents by Subjects With Chronic Kidney Disease

2005 ◽  
Vol 18 (10) ◽  
pp. 1300-1305 ◽  
Author(s):  
N BOUDVILLE ◽  
S WARD ◽  
M BENAROIA ◽  
A HOUSE
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Antihypertensive Agents

scholarly journals Optimal blood pressure for patients with chronic kidney disease: a nationwide population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
You-Bin Lee ◽  
Ji Sung Lee ◽  
So-hyeon Hong ◽  
Jung A. Kim ◽  
Eun Roh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Antihypertensive Treatment ◽  
Antihypertensive Agents ◽  
Population Based ◽  
Adverse Outcomes ◽  
Optimal Blood Pressure ◽  
Stage Renal Disease

AbstractThe effect of blood pressure (BP) on the incident cardiovascular events, progression to end-stage renal disease (ESRD) and mortality were evaluated among chronic kidney disease (CKD) patients with and without antihypertensive treatment. This nationwide study used the Korean National Health Insurance Service-Health Screening Cohort data. The hazards of outcomes were analysed according to the systolic BP (SBP) or diastolic BP (DBP) among adults (aged ≥ 40 years) with CKD and without previous cardiovascular disease or ESRD (n = 22,278). The SBP and DBP were ≥ 130 mmHg and ≥ 80 mmHg in 10,809 (48.52%) and 11,583 (51.99%) participants, respectively. During a median 6.2 years, 1271 cardiovascular events, 201 ESRD incidents, and 1061 deaths were noted. Individuals with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg had higher hazards of hypertension-related adverse outcomes compared to the references (SBP 120–129 mmHg and DBP 70–79 mmHg). SBP < 100 mmHg was associated with hazards of all-cause death, and composite of ESRD and all-cause death during follow-up only among the antihypertensive medication users suggesting that the BP should be < 130/80 mmHg and the SBP should not be < 100 mmHg with antihypertensive agents to prevent the adverse outcome risk of insufficient and excessive antihypertensive treatment in CKD patients.

scholarly journals Variation in Sodium Intake and Intra-individual Change in Blood Pressure in Chronic Kidney Disease

2018 ◽  
Vol 28 (2) ◽  
pp. 125-128
Author(s):  
Chetna M. Pathak ◽  
Joachim H. Ix ◽  
Cheryl A.M. Anderson ◽  
Tyler B. Woodell ◽  
Gerard Smits ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Individual Change

scholarly journals MEDICATION BURDEN AND INAPPROPRIATE PRESCRIPTION RISK AMONG ELDERLY WITH ADVANCED CHRONIC KIDNEY DISEASE

2019 ◽  
Author(s):  
Clarisse Roux-Marson ◽  
Jean-Baptiste Baranski ◽  
Coraline Fafin ◽  
Guillaume Extermann ◽  
Cecile Vigneau ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Healthcare Providers ◽  
Antihypertensive Agents ◽  
The Elderly ◽  
Anticholinergic Drugs ◽  
Cross Sectional ◽  
French Study ◽  
Sectional Analysis

Abstract Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were analyzed according to route of administration, therapeutic classification, and their potential inappropriateness for these patients, according to Beers' criteria. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 88% of patients had at least 1 medication classified as a RIM, and 21% of those were contraindicated drugs. At least 1 PIM was taken by 68.9%. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.

scholarly journals Benefits and Risks of Lowering Sodium Through Potassium-enriched Salt Substitution for Patients with Chronic Kidney Disease in China: A Modelling Study (OR25-05-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Matti Marklund ◽  
Gitanjali Singh ◽  
Raquel Greer ◽  
Frederick Cudhea ◽  
Kunihiro Matsushita ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Population Level ◽  
Sensitivity Analyses ◽  
Net Benefit ◽  
Uncertainty Interval ◽  
Potassium Intake ◽  
Primary Model ◽  
Cvd Mortality

Abstract Objectives Population-level replacement of discretionary (i.e, table/cooking) salt with potassium-enriched salt substitutes is a promising strategy to reduce blood pressure (BP) and prevent cardiovascular disease (CVD). This may be particularly impactful in countries like China where sodium intake is high, mainly from discretionary salt use, and where potassium intake low. However, hyperkalemia resulting from potassium-enriched substitutes and its adverse CVD consequences are of concern for those with chronic kidney disease (CKD). We aimed to estimate the benefits and risks of nationwide replacement of discretionary salt with potassium-enriched salt substitute on CVD mortality in Chinese CKD patients. Methods We used a comparative risk assessment framework and incorporated existing data and corresponding uncertainties from randomized trials, the China National Survey of CKD, the Global Burden of Disease study, and the CKD Prognosis Consortium. We estimated averted CVD mortality from reduced BP subsequent to salt substitution in CKD patients (defined as estimated glomerular filtration rate <60 mL/min per 1.73 m2) stratified by age and sex. Additional CVD deaths from hyperkalemia due to salt substitution were modelled in CKD patients stratified by kidney function. The robustness of the primary model was evaluated in a series of sensitivity analyses where key model assumptions and inputs were altered. Results Nationwide implementation of potassium-enriched salt substitution would prevent an estimated 29,735 (95% uncertainty interval: 13,018–50,403) CVD deaths/year among CKD patients by reducing BP, while the increased potassium intake could potentially produce an estimated 9791 (6078–15,941) additional hyperkalemia-related deaths (Table). The net effect would be 19,558 (3430–37,959) fewer CVD deaths/year, corresponding to 7.4% (1.4–13.4) of annual CVD deaths in Chinese CKD patients. Net benefits were consistent in sensitivity analyses (Table). Conclusions Despite the risks of hyperkalemia, nationwide potassium-enriched salt substitution in China would result in significant net benefit among CKD patients. Funding Sources This analysis was conducted in collaboration with Resolve to Save Lives, an initiative of Vital Strategies. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation. Funding for this work was also provided by the National Health and Medical Research Council and UNSW Sydney. Supporting Tables, Images and/or Graphs

scholarly journals Sodium Intake and Chronic Kidney Disease

2020 ◽  
Vol 21 (13) ◽  
pp. 4744
Author(s):  
Silvio Borrelli ◽  
Michele Provenzano ◽  
Ida Gagliardi ◽  
Michael Ashour ◽  
Maria Elena Liberti ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fluid Overload ◽  
Sodium Intake ◽  
Effective Means ◽  
Left Ventricular ◽  
Dietary Sodium ◽  
Reverse Epidemiology ◽  
Spot Urine ◽  
Adherence To Diet

In Chronic Kidney Disease (CKD) patients, elevated blood pressure (BP) is a frequent finding and is traditionally considered a direct consequence of their sodium sensitivity. Indeed, sodium and fluid retention, causing hypervolemia, leads to the development of hypertension in CKD. On the other hand, in non-dialysis CKD patients, salt restriction reduces BP levels and enhances anti-proteinuric effect of renin–angiotensin–aldosterone system inhibitors in non-dialysis CKD patients. However, studies on the long-term effect of low salt diet (LSD) on cardio-renal prognosis showed controversial findings. The negative results might be the consequence of measurement bias (spot urine and/or single measurement), reverse epidemiology, as well as poor adherence to diet. In end-stage kidney disease (ESKD), dialysis remains the only effective means to remove dietary sodium intake. The mismatch between intake and removal of sodium leads to fluid overload, hypertension and left ventricular hypertrophy, therefore worsening the prognosis of ESKD patients. This imposes the implementation of a LSD in these patients, irrespective of the lack of trials proving the efficacy of this measure in these patients. LSD is, therefore, a rational and basic tool to correct fluid overload and hypertension in all CKD stages. The implementation of LSD should be personalized, similarly to diuretic treatment, keeping into account the volume status and true burden of hypertension evaluated by ambulatory BP monitoring.

Role of Sodium Intake in the Progression of Chronic Kidney Disease

2009 ◽  
Vol 19 (1) ◽  
pp. 61-62 ◽  
Author(s):  
Eberhard Ritz ◽  
Nadezda Koleganova ◽  
Grzegorz Piecha
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake

Perceived Barriers and Support Strategies for Reducing Sodium Intake in Patients with Chronic Kidney Disease: a Qualitative Study

2014 ◽  
Vol 22 (4) ◽  
pp. 530-539 ◽  
Author(s):  
Yvette Meuleman ◽  
Lucia ten Brinke ◽  
Arjan J. Kwakernaak ◽  
Liffert Vogt ◽  
Joris I. Rotmans ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Sodium Intake ◽  
Perceived Barriers ◽  
Support Strategies

scholarly journals Achieving Salt Restriction in Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Emma J. McMahon ◽  
Katrina L. Campbell ◽  
David W. Mudge ◽  
Judith D. Bauer
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Epidemiological Studies ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Restricted Diet ◽  
Salt Restriction ◽  
Low Sodium Diet ◽  
Low Sodium

There is consistent evidence linking excessive dietary sodium intake to risk factors for cardiovascular disease and chronic kidney disease (CKD) progression in CKD patients; however, additional research is needed. In research trials and clinical practice, implementing and monitoring sodium intake present significant challenges. Epidemiological studies have shown that sodium intake remains high, and intervention studies have reported varied success with participant adherence to a sodium-restricted diet. Examining barriers to sodium restriction, as well as factors that predict adherence to a low sodium diet, can aid researchers and clinicians in implementing a sodium-restricted diet. In this paper, we critically review methods for measuring sodium intake with a specific focus on CKD patients, appraise dietary adherence, and factors that have optimized sodium restriction in key research trials and discuss barriers to sodium restriction and factors that must be considered when recommending a sodium-restricted diet.

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