Low sodium diet for dialysis patients: myth or reality?

Low salt diet for dialysis patients was recommended at the very beginning of dialysis treatment. It was issued from Kempner and Guyton studies who have established the relationship between salt, hypertension, and the rote of the kidney in sodium balance. This recommendation vanished from dialysis literature during the seventies and eighties and is currently on the way back. Salt intake has been evaluated in a small-number of patients, found between 8,3 to 14,1 gram/day. Interventional studies for salt intake restriction have been efficient to reduce high blood pressure and decrease the interdialytic weight gain. In our unit, salt restriction is systematically prescribed to chronic kidney failure patients. We have evaluated from food recall or 3-day questionnaires the salt intake in 91 hemodialysis patients during the year 2005. Dairy salt intake, not including salt added during cooking, was found at 3,8 g/day. This intake is correlated to interdialytic weight gain, water and phosphate intakes, and to BMI. Then a significant reduction in salt intake is possible in dialysis patients. This result may be obtained by the fruitful collaboration involving nurses, dieticians and the nephrologists. (C) 2007 Elsevier Masson SAS. Tous droits reserves.