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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