Moderate Sodium Research Articles

Irrigation Water Quality Assessment in Egyptian Arid Lands, Utilizing Irrigation Water Quality Index and Geo-Spatial Techniques

This study focused on assessing surface water quality in the northwest part of the Egyptian Nile Delta (El-Menoufia Governorate) and evaluated water suitability for irrigation purposes using the Irrigation Water Quality Index (IWQI), Permeability Index (PI), Wilcox, United State Salinity (USSL) diagram, and Piper trilinear diagrams categories, taking into consideration various water quality parameters. The results showed that, based on the IWQI, most of the water samples (61.8%) in the investigated area fell under the no restriction water (NR) category. Furthermore, the Wilcox diagram demonstrated that most of the investigated water samples (93.6%) are categorized as doubtful water; this shows that those samples have a higher sodium content material. According to the USSL diagram, most of the water samples (70.9%) fell into the high salinity (C) and moderate sodium (S) content (C3S2) class. According to the PI index, 8.2% of the tested water samples fell into class II (suitable for irrigation) and 91.8% fell into class III (unsuitable for irrigation). Based on the Piper trilinear, the water type is Na-Cl-HCO3. According to these results, most of the water samples require more water regulations, are categorized as doubtful water that causes plants’ augmentation sensitivity if used for irrigation, and fell into the high salinity (EC) and sodium absorption ratio (SAR) magnitude, which might have negative outcomes on soil and plant health if used for irrigation, have extensive obstacles, and are improper for irrigation. Therefore, proper management practices and treatments may be vital to mitigate the adverse effects of salinity and SAR on soil and plant health in this study area. Therefore, addressing water deficiency and quality in Egypt’s northwest Nile delta is crucial for suitable irrigation purposes.

Wood Distillate Promotes the Tolerance of Lettuce in Extreme Salt Stress Conditions.

Soil salinization is an adverse phenomenon in agriculture that severely affects crop growth and yield. The use of natural products, such as wood distillate (WD, derived from the pyrolysis of woody biomass), could be a sustainable approach to enhance the tolerance of plants cultivated in the saline soils. Hence, this study aimed to evaluate the potential of WD, a foliar sprayed at 0.2% (v/v), in lettuce plants subjected to grow under both moderate and high soil sodium chloride (NaCl) concentrations (ranging from 0 to 300 mM). The changes in the physiological and biochemical responses of these plants to the varying salt stress conditions allowed the identification of a maximum tolerance threshold (100 mM NaCl), specific to lettuce. Beyond this threshold, levels related to plant defense antioxidant power (antiradical activity) were lowered, while those indicative of oxidative stress (malondialdehyde content and electrolyte leakage) were raised, causing significant losses in leaf fresh biomass. On the other hand, WD significantly improved plant growth, enabling plants to survive high salt conditions >200 mM NaCl. Collectively, these observations highlight that treatments with WD could be of paramount importance in coping with current environmental challenges to have better yields under soil conditions of high salt concentrations.

Beneficial Effect of Faecal Microbiota Transplantation on Mild, Moderate and Severe Dextran Sodium Sulphate-Induced Ulcerative Colitis in a Pseudo Germ-Free Animal Model.

Transplantation of faecal microbiota (FMT) is generally considered a safe therapeutic procedure with few adverse effects. The main factors that limit the spread of the use of FMT therapy for idiopathic inflammatory bowel disease (IBD) are the necessity of minimising the risk of infection and transfer of another disease. Obtaining the animal model of UC (ulcerative colitis) by exposure to DSS (dextran sodium sulphate) depends on many factors that significantly affect the result. Per os intake of DSS with water is individual for each animal and results in the development of a range of various forms of induced UC. For this reason, the aim of our study was to evaluate the modulation and regenerative effects of FMT on the clinical and histopathological responses and the changes in the bowel microenvironment in pseudo germ-free (PGF) mice of the BALB/c line subjected to chemical induction of mild, moderate and serious forms of UC. The goal was to obtain new data related to the safety and effectiveness of FMT that can contribute to its improved and optimised use. The animals with mild and moderate forms of UC subjected to FMT treatment exhibited lower severity of the disease and markedly lower damage to the colon, including reduced clinical and histological disease index and decreased inflammatory response of colon mucosa. However, FMT treatment failed to achieve the expected therapeutic effect in animals with the serious form of UC activity. The results of our study indicated a potential safety risk involving development of bacteraemia and also translocation of non-pathogenic representatives of bowel microbiota associated with FMT treatment of animals with a diagnosed serious form of UC.

Analysis of spatial heterogeneity of soil physicochemical properties in northern Malawi

Topography and fertility management practices are critical when examining distribution of spatial heterogeneity of soil properties. The study was carried out on a 52-ha land with undulating topography of a village in Northern Malawi to analyze spatial soil heterogeneity with attention to topography and soil fertility management practices in 2021. The spatial heterogeneity of 12 soil chemical properties and soil texture were examined using geostatistical analysis. At 0–20 cm depth, 115 geocoded surface soil samples were collected. Remotely sensed images were captured using an unmanned aerial vehicle, processed, and analyzed to generate and visualize topographic data. Soil fertility management practices were described using field observations and questionnaire survey. The geostatistical analysis revealed spatial heterogeneity of most soil properties at a scale of 80–650 m. The spatial structure of soil pH, available phosphorus (P), total carbon (TC), total nitrogen (TN), and clay showed strong spatial autocorrelation (Q value <0.25). Calcium (Ca2+) and potassium (K+) had moderate spatial autocorrelations (Q values >0.25–< 0.75), whereas magnesium (Mg2+), sodium (Na+), sand, and silt had weak spatial autocorrelations (Q value >0.75). The spatial heterogeneity in TC, K+, Mg2+, CEC, clay, silt, and sand was influenced by the area's topography, whereas pH, P, TN, and Ca2+ were influenced by soil fertility management practices. While change can be negative or positive, differences in topography and fertility management practices significantly changed the physicochemical soil properties, and consequently affected their distribution. TN and P increased with the application of fertilizer, and manure, respectively. Increase in elevation and slope induced positive changes in CEC, K+, Mg2+ and clay. These results could be helpful in the development and application of precision agriculture in the village.

The Influence of Sodium Salt on Growth, Photosynthesis, Na+/K+ Homeostasis and Osmotic Adjustment of Atriplex canescens under Drought Stress

Atriplex canescens is widely cultivated as drought and salt-tolerant fodder in arid regions of Northwest China, which is used for photoremediation of degraded land and soil and water conservation. To explore the growth performance of A. canescens when exposed to drought and salt stress, seedlings were treated with a range of drought stress (WC1: 75 ± 3.6%, WC2: 49 ± 2.9% and WC3: 27 ± 2.5% of soil water content) and the corresponding drought stress with additional sodium salt supplementation (NaCl:Na2SO4 = 1:1 with the total concentration of Na+ set to 150 mM). The findings of this paper indicated that moderate sodium salt could stimulate the growth of A. canescens and effectively alleviate the deleterious impact of drought stress by increasing the turgor potential (ψt) and relative water content (RWC) and decreasing the leaf water osmotic potential (ψs). Furthermore, the photosynthetic capacity was improved and the negative effects of drought stress on photosystem II (PSII) were mitigated. The extra 150 mM sodium salt also markedly increased the contribution of Na+ to ψs and the contribution of betaine to ψs. In summary, these results indicate that A. canescens can adapt to drought stress by accumulating enough Na+ for osmotic adjustment (OA). Additionally, this paper is aimed to provide a fundamental basis for the utilization and cultivation of A. canescens as a favored pasture crop in the Qaidam basin, thus increasing the ecological and environmental benefits for arid regions worldwide.

Abstract P379: Acute Mineralocorticoid Receptor Antagonism Does Not Alter Insulin Sensitivity Or Secretion In Metabolic Syndrome

We previously demonstrated that maximal dietary sodium restriction impairs insulin secretion in humans, and that aldosterone impairs insulin secretion ex vivo in isolated islets. Aldosterone is inappropriately elevated in obesity and metabolic syndrome, but it is unknown if mineralocorticoid receptor antagonism with eplerenone improves insulin secretion in metabolic syndrome (MS) during moderate sodium restriction. We hypothesized that eplerenone would improve insulin secretion and insulin sensitivity in participants with the metabolic syndrome. We conducted a randomized, double-blind cross-over study in 16 volunteers with MS and elevated blood pressure in whom we provided either Eplerenone 50 mg or Amlodipine 5 mg and a standardized 50mmol Na/day diet for 7 days. Insulin sensitivity was assessed with hyperinsulinemic clamp and insulin secretion was assessed with hyperglycemic clamp at 5 and 7 days of diet, respectively. EPL increased plasma aldosterone compared to AML treatment (19.8±9.3 vs 12.2±3.9 ng/dL, in EPL and AML, respectively; mean±SD, for all descriptions; P &lt;0.001) but did alter systolic blood pressure (127.5±15.6 vs 124.5±14.5 mmHg; P =0.51). EPL did not alter insulin sensitivity assessed by hyperinsulinemic clamp (19.3±7.8 vs 18.7±7.3 μg/kg/min per uU/mL Insulin; P =0.82).Fasting glucose (101.8±9.0 vs 100.5±6.8 mg/dL, P=0.76) and insulin (28.1±18.0 vs 23.9±12.7 μU/mL; P =0.7) were similar during EPL treatment. EPL did not alter acute glucose-stimulated insulin secretion (68.2±45.5 vs 58.7±43.7 μU/ml; P =0.7) or L-arginine stimulated insulin secretion (578±238 vs 579±228 μU/ml; P =0.8) assessed by hyperglycemic clamp. Disposition index was similarly unchanged (1.2±0.8 vs 1.1±0.9; P =0.8). We conclude that mineralocorticoid receptor antagonism with eplerenone during 7 days of moderate sodium restriction does not alter insulin sensitivity or insulin secretion in Metabolic Syndrome.

Hydro-geochemical assessment of ground water for drinking and agricultural purposes and potential human health risk in Aligarh city, India

Health effects are related globally to water quality. The residents of Aligarh city are solely rely on groundwater for drinking and domestic purposes. The aim of the study was to find out association between ground water quality and water borne diseases. For this purpose, the present study evaluated physicochemical quality of drinking water. The water quality was evaluated for both pre-monsoon (PRM) and post-monsoon (POM) seasons based on samples collected from 19 stations. To find the potential health risk and waterborne diseases vulnerability, questionnaires-based survey was carried out. Although most of the samples range slightly above the Bureau of Indian Standard's (BIS) permissible limit, the results revealed the sign of contamination from the surface of the earth. According to result of water quality index, the city is classified as having well to moderate water quality throughout the year. The correlation, HCA, and Trilinary plot demonstrate that natural pollution sources, human activities, and geographical factors affecting water quality in the study area. During PRM, 84.21% area falls under slight to moderate sodium hazard category where as the result gets better during POM where 68.42% area falls under the same category. Overall, the water was fit to be used for irrigation purposes. The accuracy of WBD's susceptibility maps was assessed by RMSE. During PRM, chemical parameters in groundwater, WQI and WBD's RMSE were found to be 0.1483, 0.3157 and 0.212 whereas during POM the results were 0.1822, 0.3172 and 0.1966, respectively. The results obtained from susceptibility assessment shows that drinking water will not have any major waterborne diseases. However, the result revealed that POM season is more vulnerable to some waterborne diseases than the PRM season.

Dietary counseling to reduce moderate sodium intake. Concerns about the methods, evidence and feasibility of lowering sodium intake.

Dietary counseling to reduce moderate sodium intake. Concerns about the methods, evidence and feasibility of lowering sodium intake.

Cultivation of Spirulina platensis for nutrient removal from piggery wastewater.

The discharge of livestock wastewater without appropriate treatment causes severe harm to the environment and human health. In the pursuit of finding solutions to this problem, the cultivation of microalgae as feedstock for biodiesel and animal feed additive using livestock wastewater coupled with the removal of nutrients from wastewater has become a hot research topic. In this study, the cultivation of Spirulina platensis using piggery wastewater for the production of biomass and the removal of nutrients were studied. The results of single factor experiments confirmed that Cu2+ seriously inhibit the growth of Spirulina platensis, while the influences of nitrogen, phosphorous, and zinc on the growth of Spirulina platensis can all be described as "low promotes high inhibits." Spirulina platensis grew well in the 4-fold dilution of piggery wastewater supplemented with moderate sodium bicarbonate, which indicated that it is the limiting nutrients for Spirulina platensis growth in piggery wastewater. The biomass concentration of Spirulina platensis reached 0.56g/L after 8days of culture at the optimal conditions proposed by the response surface method, which were as follows: 4-fold dilution of piggery wastewater, 7g/L sodium bicarbonate, pH of 10.5, initial OD560 of 0.63, light intensity of 3030lx, and light time/dark time of 16h/8h. Spirulina platensis cultured in the diluted piggery wastewater contained 43.89% protein, 9.4% crude lipid, 6.41mg/g chlorophyll a, 4.18% total sugar, 27.7mg/kg Cu, and 246.2mg/kg Zn. The removal efficiency for TN, TP, COD, Zn, and Cu from the wastewater by Spirulina platensis was 76%, 72%, 93.1%, 93.5%, and 82.5%, respectively. These results demonstrated the feasibility of piggery wastewater treatment by the cultivation of Spirulina platensis.

Properties and microstructures of golden thread fish myofibrillar proteins gel filled with diacylglycerol emulsion: Effects of emulsifier type and dose

In this study, diacylglycerol (DAG) emulsions stabilized by different concentrations of sodium caseinate (SCE) or Tween 80 (TWE) were prepared and characterized, and the effects of prepared emulsions as fillers on the gel properties, microstructures and molecular interactions of myofibrillar proteins (MP) gel were investigated. The particle size of SCE decreased gradually with the amount of sodium caseinate, and the minimum value was obtained with 2.5% sodium caseinate. The filling of SCE enhanced the whiteness, water-holding capacity (WHC), gel strength, and texture (P < 0.05), and facilitated the formation of a more compact gel network with sufficient emulsion droplets to be fixed in it. This positive effect was based on various interactions between SCE droplets and MP, and showed sodium caseinate dosage dependence within a certain range. In addition, TWE obtained the most effective particle size at 1.0% Tween 80 dosage, which had no adverse effect on gel properties. However, when Tween 80 concentration exceeded 1.5%, MP gel's water retention, strength, and texture properties showed a certain downward trend, accompanied by the weakening of gel network and the loss of more oil droplets. These results support that DAG emulsion stabilized by moderate sodium caseinate is a potential active filler, which can not only enhance the content of unsaturated fatty acids in gels, but also improve the gel properties.

Dopamine Receptor D1R and D3R and GRK4 Interaction in Hypertension.

Essential hypertension is caused by the interaction of genetic, behavioral, and environmental factors. Abnormalities in the regulation of renal ion transport cause essential hypertension. The renal dopaminergic system, which inhibits sodium transport in all the nephron segments, is responsible for at least 50% of renal sodium excretion under conditions of moderate sodium excess. Dopaminergic signals are transduced by two families of receptors that belong to the G protein-coupled receptor (GPCR) superfamily. D1-like receptors (D1R and D5R) stimulate, while D2-like receptors (D2R, D3R, and D4R) inhibit adenylyl cyclases. The dopamine receptor subtypes, themselves, or by their interactions, regulate renal sodium transport and blood pressure. We review the role of the D1R and D3R and their interaction in the natriuresis associated with volume expansion. The D1R- and D3R-mediated inhibition of renal sodium transport involves PKA and PKC-dependent and -independent mechanisms. The D3R also increases the degradation of NHE3 via USP-mediated ubiquitinylation. Although deletion of Drd1 and Drd3 in mice causes hypertension, DRD1 polymorphisms are not always associated with human essential hypertension and polymorphisms in DRD3 are not associated with human essential hypertension. The impaired D1R and D3R function in hypertension is related to their hyper-phosphorylation; GRK4γ isoforms, R65L, A142V, and A486V, hyper-phosphorylate and desensitize D1R and D3R. The GRK4 locus is linked to and GRK4 variants are associated with high blood pressure in humans. Thus, GRK4, by itself, and by regulating genes related to the control of blood pressure may explain the "apparent" polygenic nature of essential hypertension.

Dietary counselling to reduce moderate sodium intake: effects on cardiovascular and renal biomarkers: primary findings of the COSIP and STICK phase II feasibility randomised controlled trials.

While low sodium intake (<2.3g/day) is recommended, there is uncertainty about long-term feasibility and effects on cardiorenal biomarkers in populations with moderate intake. In two phase IIb, feasibility, randomised, parallel, open-label, controlled, single-centre trials, individuals aged >40 years with stable blood pressure (BP), without heart failure or postural hypotension were randomised to intensive dietary counselling (target sodium intake <2.3g/day) or usual care between March 2016 and July 2018. One trial included participants with chronic kidney disease (CKD); the other excluded those with CKD or cardiovascular disease. All participants received healthy eating advice. Primary outcomes were NT-pro B-type natriuretic peptide (NT-proBNP), high sensitivity troponin T (hsTnT), C-reactive protein (CRP), renin, aldosterone and, creatinine clearance (CrCl) at 2-years. These trials are registered with ClinicalTrials.gov, STICK trial (NCT02458248) and COSIP trial (NCT02738736). 373 participants, with mean 24-h urine sodium 3.16±1.47g/day, were randomised to intervention (n=187) or usual care (n=186). At 3-months, the intervention reduced 24-h urine sodium (intervention-0.11g/day, usual care+0.28g/day, p=0.003), BP (systolic-2.52mmHg, p=0.05; diastolic-1.92, p=0.02) and increased renin (+33.35 mIU/L [95%CI 3.78-62.91]). At 2-years, the intervention significantly reduced self-reported salt use (p<0.001), but not 24-h urine sodium (intervention-0.23g/day, usual care+0.05g/day, p=0.47). At 2-years, there were no significant between-group differences in BP (systolic p=0.66; diastolic p=0.09), NT-proBNP (p=0.68), hsTnT (p=0.20), CRP (p=0.56), renin (p=0.52), aldosterone (p=0.61), or CrCl (p=0.68). Among individuals with moderate sodium intake, intensive dietary counselling resulted in small short-term reductions in sodium intake and BP, but no significant effect on sodium intake, BP, or cardiorenal biomarkers at two years. Our trial suggests that it may not feasible to reduce sodium sustainably in those with a sodium intake around 3.0g/day, through an intensive dietary counselling intervention. The STICK trial was funded by the Health Research Board of Ireland and the COSIP trial was funded by the European Research Council.

Associations between 24-hour urinary sodium excretion and all-cause mortality in adults living in north China

Objective: To investigate the associations between 24-hour urinary sodium excretion (24hUNaE) and all-cause mortality in adult Northern Chinese population. Methods: Data from this study were derived from the prospective urban and rural epidemiology (PURE) study in north China. Baseline information of all participants were obtained by face to face interview through trained research staffs based on questionnaires, and morning fasting urine samples of participants were collected to estimate 24hUNaE and 24-hour potassium excretion (24hUKE). Multivariable frailty Cox regression models were used to explore the association between 24hUNaE (<3.00, 3.00-3.99, 4.00-4.99, 5.00-5.99 and ≥6 g/d) and all-cause death. Results: A total of 27 310 participants were included in this study. The mean 24hUNaE was (5.84±1.73) g/d. After a median follow-up of 8.8 years, 1 024 participants died (3.7%), including 390 cardiovascular related deaths and 591 non-cardiovascular related deaths. The cause of death of the remaining patients could not be determined. Using 24hUNaE level of 4.00-4.99 g/d as the reference group, after fully adjustment, 24hUNaE ≥6.00 g/d was associated with an increased risk of all-cause death (HR=1.24, 95%CI: 1.02-1.49) and cardiovascular related death (HR=1.39, 95%CI: 1.02-1.88). 24hUNaE<3.00 g/d was associated with increased risk of all-cause mortality (HR=1.38, 95%CI: 0.96-1.99). There was no significant association between 24hUNaE and non-cardiovascular related death. Furthermore, using the combination of 24hUNaE 4.00-4.99 g/d and 24hUKE≥2.11 g/d as the reference group, the highest risk occurred in participants with the combination of low sodium (<3.00 g/d) and low potassium (<2.11 g/d). Conclusion: 24hUNaE equal or higher than 6 g/d or lower than 3 g/d is associated with increased risk of all-cause mortality and cardiovascular related death in Northern Chinese population. Besides, moderate sodium intake in combination with increased potassium intake might reduce the risk of all-cause death.

Salt Eustress Induction in Red Amaranth (Amaranthus gangeticus) Augments Nutritional, Phenolic Acids and Antiradical Potential of Leaves.

Earlier researchers have highlighted the utilization of salt eustress for boosting the nutritional and phenolic acid (PA) profiles and antiradical potential (ARP) of vegetables, which eventually boost food values for nourishing human diets. Amaranth is a rapidly grown, diversely acclimated C4 leafy vegetable with climate resilience and salinity resistance. The application of salinity eustress in amaranth has a great scope to augment the nutritional and PA profiles and ARP. Therefore, the A. gangeticus genotype was evaluated in response to salt eustress for nutrients, PA profile, and ARP. Antioxidant potential and high-yielding genotype (LS1) were grown under four salt eustresses (control, 25 mM, 50 mM, 100 mM NaCl) in a randomized completely block design (RCBD) in four replicates. Salt stress remarkably augmented microelements, proximate, macro-elements, phytochemicals, PA profiles, and ARP of A. gangeticus leaves in this order: control &lt; low sodium chloride stress (LSCS) &lt; moderate sodium chloride stress (MSCS) &lt; severe sodium chloride stress (SSCS). A large quantity of 16 PAs, including seven cinnamic acids (CAs) and nine benzoic acids (BAs) were detected in A. gangeticus genotypes. All the microelements, proximate, macro-elements, phytochemicals, PA profiles, and ARP of A. gangeticus under MSCS, and SSCS levels were much higher in comparison with the control. It can be utilized as preferential food for our daily diets as these antiradical compounds have strong antioxidants. Salt-treated A. gangeticus contributed to excellent quality in the end product in terms of microelements, proximate, macro-elements, phytochemicals, PA profiles, and ARP. A. gangeticus can be cultivated as an encouraging substitute crop in salt-affected areas of the world.

Dietary Aspects and Drug-Related Side Effects in Autosomal Dominant Polycystic Kidney Disease Progression.

Autosomal dominant polycystic kidney disease (ADPKD) is the most commonly inherited kidney disease. In the absence of targeted therapies, it invariably progresses to advanced chronic kidney disease. To date, the only approved treatment is tolvaptan, a vasopressin V2 receptor antagonist that has been demonstrated to reduce cyst growth and attenuate the decline in kidney function. However, it has various side effects, the most frequent of which is aquaresis, leading to a significant discontinuation rate. The strategies proposed to combat aquaresis include the use of thiazides or metformin and a reduction in the dietary osmotic load. Beyond the prescription of tolvaptan, which is limited to those with a rapid and progressive decline in kidney function, dietary interventions have been suggested to protect against disease progression. Moderate sodium restriction, moderate protein intake (up to 0.8 g/kg/day), avoidance of being overweight, and increased water consumption are recommended in ADPKD guidelines, though all with low-grade evidence. The aim of the present review is to critically summarize the evidence on the effect of dietary modification on ADPKD and to offer some strategies to mitigate the adverse aquaretic effects of tolvaptan.

Abstract P329: Moderate Dietary Sodium Restriction Does Not Alter Insulin Sensitivity Or Secretion In Metabolic Syndrome

We previously demonstrated that maximal dietary sodium restriction (10mmol/d) decreases insulin secretion and impairs insulin secretion. It is unclear if dietary changes other than NaCL account for this and if more moderate sodium restriction reflecting clinically achievable ranges would alter glucose metabolism. We therefore hypothesized that moderate diet-induced stimulation of the renin-angiotensin-aldosterone system would impair insulin secretion in participants with the metabolic syndrome. We conducted a randomized, double-blind cross-over study in 29 volunteers in which we provided a standardized 50mmol Na/day diet for 7 days. Participants were provided encapsulated NaCl 150 mEq/d (High Sodium, HS) or matching placebo capsule (Low Sodium, LS) for 7 days. Insulin sensitivity was assessed with hyperinsulinemic clamp and insulin secretion was assessed with hyperglycemic clamp at 5 and 7 days of diet, respectively. LS diet increased plasma aldosterone compared to HS diet (15.2±6.2 vs 10.8±3.2; P &lt;0.001) but did alter blood pressure (126.5±13.6 vs 128.7±13.9 mmHg; P =0.49). Fasting glucose and insulin were similar during LS diet. As assessed by hyperinsulinemic clamps, insulin sensitivity was similar (0.2756 ± 0.0771 vs 0.2917 ± 0.0722 mg/kg/min per uU/mL Insulin; P =0.49). Insulin clearance tended to decrease during the LS period (980 ± 410 vs 1127 ± 366; P=0.10). There was no difference in glucose-stimulated insulin secretion assessed by hyperglycemic clamp (55.3 ± 47.7 vs 50.0 ± 36.7 uU/ml; P=0.7). Dietary sodium restriction achievable dose not alter glucose and insulin metabolism in the short term.

Effect of a sodium restriction diet on albuminuria and blood pressure in diabetic kidney disease patients: a meta-analysis.

A sodium restriction diet is a key component of chronic kidney disease (CKD) management. However, the efficacy of its use in patients with diabetic kidney disease (DKD) is uncertain. The present meta-analysis explored the effects of restricting sodium intake on albuminuria and blood pressure in DKD patients with albuminuria. We searched the Cochrane Central Register of Controlled Trials, Web of Science, MEDLINE, and EMBASE for randomized controlled trials, and we reviewed the references of all searched articles to avoid omitting other relevant articles. Our primary endpoints were blood pressure, albumin excretion rate, and plasma renin activity. We assessed pooled data using a random-effects model. Of the 661 articles identified, a total of 12 articles were included in the meta-analysis. The random-effects model indicated that salt-restriction diet interventions led to a poled - 4.72mmHg (95% CI - 6.71, - 2.73) difference in systolic blood pressure and that the intervention resulted in a 2.33mmHg lower diastolic blood pressure (95% CI - 3.61, - 1.05). In patients with microalbuminuria, restricted sodium intake decreased the albumin excretion rate (AER) by 12.62mg/min (95% CI - 19.64, - 5.60). Furthermore, the AER was 127.69mg/min lower in patients with macroalbuminuria (95% CI - 189.07, - 66.32). Moderate sodium restriction diets reduce urinary albumin excretion and decrease the level of blood pressure, especially for patients with macro-albuminuria. Thus, it is necessary to strengthen the intervention and health education as well as to provide individualized dietary advice.

Sodium and/or fluid restriction and nutritional parameters of adult patients with heart failure: A systematic review and meta-analysis of randomized controlled trial.

Heart failure (HF) is a clinical syndrome resulting from the structural and/or functional impairment of blood supply to tissues. Congestion and edema associated with water retention are the main symptoms presented by patients. Fluid (FR) and sodium restriction are non-pharmacological measures indicated in clinical practice to mitigate this symptom, despite their low evidence level. Assessing the impact of sodium and/or fluid restriction on nutritional parameters of adult patients with HF, based on systematic review with meta-analysis. The study was conducted in June 2020, on the following databases: EMBASE, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science. Citations were also collected in the gray literature such as thesis banks and preprints. Randomized clinical trials conducted with patients in the age group 18 years, or older, who were hospitalized or under outpatient/clinical follow-up, and who were subjected to intervention based on fluid and/or sodium restriction in comparison to the control, were herein selected. Although FR-based diets are effective in reducing liquid intake, they increase individuals' thirst sensation and body weight in comparison to non-FR diets. The association between this intervention and sodium restriction is also effective in reducing liquid intake as sodium intake decreases. However, the association of the most severe (<2000mg/day) and moderate (2000-2400mg/day) sodium restrictions with FR has reduced energy intake, although without evidence of weight change - only the most severe sodium restriction was capable of keeping individuals' thirst sensation. In addition, moderate sodium restrictions (2300 to 3000mg/day) in association with FR were capable of decreasing urinary sodium excretion. On the other hand, prescriptions of severe or moderate sodium restriction (<2,400mg/d) alone have reduced individuals' body weight and BMI, although they did not change their caloric intake. However, severe sodium restriction (<2,000mg) has led to higher body weight than the low-sodium diet (2000 to 2,4000mg/day). Sodium restriction may not be an effective strategy because it adversely affects individuals' weight, a fact that suggests increased congestion. Weight-based FR is supported to bethe best way to individualize this non-pharmacological treatment and it does not appear to affect nutritional parameters capable of putting patients with HF at higher malnutrition risk.

Plant-Based Milk Alternatives and Risk Factors for Kidney Stones and Chronic Kidney Disease

Patients with kidney stones are counseled to eat a diet low in animal protein, sodium, and oxalate and rich in fruits and vegetables, with a modest amount of calcium, usually from dairy products. Restriction of sodium, potassium, and oxalate may also be recommended in patients with chronic kidney disease. Recently, plant-based diets have gained popularity owing to health, environmental, and animal welfare considerations. Our objective was to compare concentrations of ingredients important for kidney stones and chronic kidney disease in popular brands of milk alternatives. Sodium, calcium, and potassium contents were obtained from nutrition labels. The oxalate content was measured by ion chromatography coupled with mass spectrometry. The calcium content is highest in macadamia followed by soy, almond, rice, and dairy milk; it is lowest in cashew, hazelnut, and coconut milk. Almond milk has the highest oxalate concentration, followed by cashew, hazelnut, and soy. Coconut and flax milk have undetectable oxalate levels; coconut milk also has comparatively low sodium, calcium, and potassium, while flax milk has the most sodium. Overall, oat milk has the most similar parameters to dairy milk (moderate calcium, potassium and sodium with low oxalate). Rice, macadamia, and soy milk also have similar parameters to dairy milk. As consumption of plant-based dairy substitutes increases, it is important for healthcare providers and patients with renal conditions to be aware of their nutritional composition. Oat, macadamia, rice, and soy milk compare favorably in terms of kidney stone risk factors with dairy milk, whereas almond and cashew milk have more potential stone risk factors. Coconut milk may be a favorable dairy substitute for patients with chronic kidney disease based on low potassium, sodium, and oxalate. Further study is warranted to determine the effect of plant-based milk alternatives on urine chemistry.

Long-term dietary nitrate supplementation does not reduce renal cyst growth in experimental autosomal dominant polycystic kidney disease.

Augmentation of endogenous nitric oxide (NO) synthesis, either by the classical L-arginine-NO synthase pathway, or the recently discovered entero-salivary nitrate-nitrite-NO system, may slow the progression of autosomal dominant polycystic kidney disease (ADPKD). To test this hypothesis, the expression of NO in human ADPKD cell lines (WT 9-7, WT 9-12), and the effect of L-arginine on an in vitro model of three-dimensional cyst growth using MDCK cells, was examined. In addition, groups of homozygous Pkd1RC/RC mice (a hypomorphic genetic ortholog of ADPKD) received either low, moderate or high dose sodium nitrate (0.1, 1 or 10 mmol/kg/day), or sodium chloride (vehicle; 10 mmol/kg/day), supplemented drinking water from postnatal month 1 to 9 (n = 12 per group). In vitro, intracellular NO, as assessed by DAF-2/DA fluorescence, was reduced by >70% in human ADPKD cell lines, and L-arginine and the NO donor, sodium nitroprusside, both attenuated in vitro cyst growth by up to 18%. In contrast, in Pkd1RC/RC mice, sodium nitrate supplementation increased serum nitrate/nitrite levels by ~25-fold in the high dose group (P<0.001), but kidney enlargement and percentage cyst area was not altered, regardless of dose. In conclusion, L-arginine has mild direct efficacy on reducing renal cyst growth in vitro, whereas long-term sodium nitrate supplementation was ineffective in vivo. These data suggest that the bioconversion of dietary nitrate to NO by the entero-salivary pathway may not be sufficient to influence the progression of renal cyst growth in ADPKD.