| Objective To investigate the effects of dietary sodium restriction on proteinuria and blood pressure in patients with chronic kidney disease treated on renin-angiotensin aldosterone system blockade,and to explore whether dietary sodium restriction can enhance the renal protective effect of RAAS blockade on patients with chronic kidney disease.Methods Forty-six patients with primary chronic glomerulonephritis who were treated with nephrology from Hangzhou Hospital of Traditional Chinese Medical from January 2016 to January 2017 were randomly divided into experimental group(n = 23)and control group(n = 23).Two groups of patients were treated with routine nephrotic diet,on the basis of diet the experimental group was treated with a restricted sodium diet;while control group was treated with a free diet.The differences of the 24-hour urinary protein,urinary protein/creatinine ratio,blood pressure and kidney function(glomerular filtration rate)were compared between two groups at weeks 0 and 8.Results 1 case lost contact and 2 cases withdrew from the experimental group,and 20 cases actually completed;2 cases lost contact and 2 cases withdrew from the control group,and 19 cases actually completed.There was no significant difference between the two groups in baseline data(P>0.05).The mean amount of urinary sodium was(113.78±35.38)mmol/d in the experimental group,and(168.61±67.90)mmol/d in the control group during the intervention.The main results are as follows:①After 8 weeks of intervention,the 24-hour urinary protein was decreased from(0.49 ± 0.29)g/d to(0.26 ± 0.15)g/d(P<0.01)in the experimental group and from(0.50 ±0.23)g/d to(0.37±0.19)g/d in the control group(P<0.05).The urinary protein in the experimental group was significantly lower than that in the control group(P<0.05).The urinary protein/creatinine ratio was decreased from(0.57±0.46)g/gCr to(0.29±0.18)g/gCr(P<0.01)in the experimental group and from(0.46±0.30)g/gCr to(0.36±0.24)g/gCr in the control group(P>0.05).There was no significant difference in urinary protein/creatinine ratio between the two groups(P>0.05).②After 8 weeks of intervention,there was no significant difference in blood pressure between the two groups(P>0.05).The mean arterial pressure was decreased from(85.90 ± 6.15)mmHg to(83.53 ± 7.44)mmHg in the experimental group,and from(87.67 ± 8.66)mmHg to(83.02 ± 6.29)mmHg in the control group.③After 8 weeks of intervention,there was no significant difference in renal function between the two groups(P>0.05).The glomerular filtration rate was increased from(93.70 ± 34.24)ml/min to(98.75 ± 31.83)ml/min in the experimental group,and decreased from to(91.31±23.63)ml/min to(90.24±23.85)ml/min in the control group,and there was no significant difference between the two groups before and after the intervention(P>0.05).Conclusion Restricted sodium diet can enhance the efficacy of RAAS blockade to reduce proteinuria,but have no significant effect on kidney function. |
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