Effects Of Lowering Sodium Intake On Progression Of Chronic Kidney Disease:Systematic Review And Meta-analysis

Objective To assess the effects of lowering sodium intake on progression of chronic kidney disease,through the systematic review and meta-analysis of related researches assessing the benefits and harms of lowering dietary salt intake in people with CKD.Methods We searched Cochrane Central Register of Controlled Trials, MEDLINE,EMBASE in English and CNKI, Wanfang data, CBM in Chinese(all from the day libraries built up to April 2016), searched bibliographies of relevant papers and the ongoing research, in order to identify appropriate articles. We included all randomised controlled trials and randomized crossover trials of salt reduction in individuals with chronic kidney disease. Two authors independently assessed studies and resolved differences by discussion with a third independent author. RevMan 5.3 software was used for meta-analysis.Results Fifteen articles met our inclusion criteria. These included 765 individuals with chronic kidney disease. The meta-analysis results showed that changes happened with salt restriction: ① Blood pressure was reduced [systolic blood pressure:MD=-6.46,95%CI (-8.19,-4.72),P<0.001;diastolic blood pressure:MD=-3.05,95%CI (-3.83,-2.28), P< 0.001]; ②Among individuals with chronic kidney disease without diabetes,reduced dietary salt was associated with diminished proteinuria.Among individuals with chronic kidney disease with diabetes,reduced dietary salt was associated with diminished proteinuria in type 2 diabetes patients with microalbuminuria;③ GFR was reduced[MD=-3.47,95%CI (-6.21,-0.73),P=0.01].Conclusion This meta-analysis shows that lowering sodium intake decelerates renal disease progression,the way is efficient and safe currently.