Browse Ideas with tag 'sodium':

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  CKD »

  What is the optimum dietary sodium intake in CKD?

  A lower Na diet has been suggested for CKD patients, and may help reduce proteinuria, but impact on progression has not been proven, and in heart failure, the role of a low sodium diet is being questioned (see Rothberg et al, J Gen Intern Med 25(10):1136–7, 2010). Proposed would be a randomized study in proteinuric diabetic CKD patients with target dietary Na of 1.5 vs. 3.0 g/day, with endpoints being 50% reduction in ...more »

  A lower Na diet has been suggested for CKD patients, and may help reduce proteinuria, but impact on progression has not been proven, and in heart failure, the role of a low sodium diet is being questioned (see Rothberg et al, J Gen Intern Med 25(10):1136–7, 2010).

  Proposed would be a randomized study in proteinuric diabetic CKD patients with target dietary Na of 1.5 vs. 3.0 g/day, with endpoints being 50% reduction in estimated cystatin GFR or dialysis/transplantation.

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  Submitted by John Daugirdas 2 years ago

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  AKI »

  What is the optimum serum Na level for AKI patients on CRRT?

  The acceptable serum Na level for ICU patients with AKI ranges from 133-148 mM. Administration of low Na fluids tends to keep serum Na ~135, whereas a higher serum Na of ~ 145 may help mobilize interstitial fluid and help lung compliance. An RCT is proposed for patients receiving CRRT where attempts would be made to keep serum Na close to either 136 vs. 144 mM, with the hypothesis that edema mobilization and lung compliance ...more »

  The acceptable serum Na level for ICU patients with AKI ranges from 133-148 mM. Administration of low Na fluids tends to keep serum Na ~135, whereas a higher serum Na of ~ 145 may help mobilize interstitial fluid and help lung compliance. An RCT is proposed for patients receiving CRRT where attempts would be made to keep serum Na close to either 136 vs. 144 mM, with the hypothesis that edema mobilization and lung compliance would be enhanced at the higher serum Na level.

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  Submitted by John Daugirdas 2 years ago

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  ESRD/DIALYSIS »

  Effect of low sodium and low phosphate diet on outcomes in ESRD

  Data by Ozkahya et al (NDT 1988) suggested that sodium restriction and volume control could markedly reduce left ventricular mass index (LVMI). Ayus et al. (JASN 2005) found that LVMI reduction with daily dialysis correlated with better control of serum phosphate (P). Guida et al found that serum P could be reduced in 3/week patients using a low P, whey-substituted diet. The ability to maintain a low sodium (e.g., ...more »

  Data by Ozkahya et al (NDT 1988) suggested that sodium restriction and volume control could markedly reduce left ventricular mass index (LVMI). Ayus et al. (JASN 2005) found that LVMI reduction with daily dialysis correlated with better control of serum phosphate (P). Guida et al found that serum P could be reduced in 3/week patients using a low P, whey-substituted diet. The ability to maintain a low sodium (e.g., ~1.0 g/day) or low P (~0.6 g/day) diet in ESRD patients, or the effect of such diets on either surrogate outcomes (e.g. LVMI) or hard outcomes (survival, hospitalizations) has not been examined in a randomized trial. Proposed is a study, with patients randomized to either low Na / normal Na, and low P / normal P diets using a 2 x 2 factorial design in 3/week hemodialysis patients; a pilot study to look at feasibility with a main surrogate outcome of LVMI (200 patients), and a hard outcomes study (2000 patients) to look at mortality and hospitalizations.

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  Submitted by John Daugirdas 2 years ago

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