Abstract
Dietary salt restriction is essential for managing fluid retention in patients with chronic kidney disease (CKD). In this retrospective cohort study, we investigated weight loss from the perspective of fluid status in CKD patients during a 7-day hospitalization period while consuming a low-salt diet (5 g/day). Among 311 patients, the median weight loss (interquartile range, maximum) was 0.7 (0.0–1.4, 4.7) kg on Day 4 and 1.0 (0.3–1.7, 5.9) kg on Day 7. Patients were classified into quartiles based on pre-hospital urinary salt excretion (quartile [Q] 1, 1.2–5.7; Q2, 5.8–8.4; Q3, 8.5–11.3; Q4, 11.4–29.2 g/day). Weight loss was significantly greater in Q3 and Q4 than in Q1. The body mass index (BMI) and urinary salt excretion in the first 24 hours after admission were independently associated with rapid weight loss on Day 4 by multivariate logistic regression analysis. In conclusion, CKD patients with a high salt intake or high BMI exhibit rapid weight loss within a few days of consuming a low-salt diet. Dietary salt restriction is effective for reducing proteinuria in these patients, but long-term observation is needed to confirm the sustained effects.
Highlights
Chronic kidney disease (CKD) can cause fluid retention, mainly due to reduced glomerular filtration of sodium and activation of the renin-angiotensin system
Weight loss with dietary salt restriction may be greater in chronic kidney disease (CKD) patients with a higher salt intake or higher body mass index (BMI)
Proteinuria can be decreased by dietary salt restriction in CKD patients with a high salt intake
Summary
Chronic kidney disease (CKD) can cause fluid retention, mainly due to reduced glomerular filtration of sodium and activation of the renin-angiotensin system. Fluid retention is related to hypertension in CKD patients and salt sensitivity of blood pressure increases with decreasing kidney function[5]. CKD patients with apparent fluid retention frequently experience rapid weight loss within a few days of consuming a low-salt diet during hospitalization. This decrease in body weight has been considered to occur due to reduced fluid retention. We investigated the short-term effects of dietary salt restriction on weight loss from the perspective of fluid status in CKD patients. We performed a multivariate logistic regression analysis to identify the factors related to rapid weight loss in response to dietary salt restriction
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