Aim

Lifestyle modifications can postpone the progression of chronic kidney disease toward its terminal stage. This mini-review aims to explore the impact of salt and water intake on the progression of chronic kidney disease (CKD) and provide insights into the optimal consumption levels to preserve the glomerular filtration rate.

Methods

We reviewed relevant literature to examine the association between salt and water consumption and CKD progression. Our analysis includes discussions on the pathophysiology, findings from clinical trials, and recommended intake guidelines.

Results

Sodium intake, often linked to cardiovascular risk and CKD progression, has shown a complex J-shaped association in some studies, leading to uncertainty about the ideal salt intake level. Sodium and fluid retention are key factors contributing to hypertension, a well-established risk factor for CKD progression. Low-sodium diets have demonstrated promise in reducing blood pressure and enhancing the effects of renin–angiotensin–aldosterone system inhibitors in non-dialysis CKD patients. However, a debate persists regarding the independent effect of salt restriction on CKD progression. Despite medical recommendations, salt consumption remains high among CKD patients. Additionally, the role of water consumption in CKD remains controversial despite its established benefits for CKD prevention in the general population.

Conclusion

Lifestyle modifications involving salt and water intake can influence the progression of CKD. While low-sodium diets have shown potential for mitigating hypertension and proteinuria in non-dialysis CKD patients, their independent impact on CKD progression warrants further investigation. The role of water consumption in CKD remains uncertain, and there is a need for additional research in this area. Clinicians should consider individualized dietary recommendations for CKD patients to help preserve the glomerular filtration rate and improve overall outcomes.

中文翻译：

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慢性肾脏病进展中的钠和水动态：机制和临床意义

目的

生活方式的改变可以延缓慢性肾病的进展至晚期。这篇小型综述旨在探讨盐和水的摄入量对慢性肾脏病 (CKD) 进展的影响，并深入了解维持肾小球滤过率的最佳摄入水平。

方法

我们回顾了相关文献，以研究盐和水的消耗与 CKD 进展之间的关联。我们的分析包括对病理生理学的讨论、临床试验的结果以及推荐的摄入指南。

结果

钠摄入量通常与心血管风险和 CKD 进展相关，在一些研究中显示出复杂的 J 形关联，导致理想盐摄入量的不确定性。钠和液体潴留是导致高血压的关键因素，而高血压是 CKD 进展的公认危险因素。低钠饮食已被证明可以降低非透析 CKD 患者的血压并增强肾素-血管紧张素-醛固酮系统抑制剂的效果。然而，关于限盐对 CKD 进展的独立影响仍然存在争议。尽管有医学建议，慢性肾病患者的食盐摄入量仍然很高。此外，尽管饮水对于普通人群预防 CKD 有好处，但它在 CKD 中的作用仍然存在争议。

结论

涉及盐和水摄入的生活方式改变可能会影响 CKD 的进展。虽然低钠饮食已显示出缓解非透析 CKD 患者高血压和蛋白尿的潜力，但其对 CKD 进展的独立影响值得进一步研究。水消耗在 CKD 中的作用仍不确定，需要在该领域进行更多研究。临床医生应考虑为 CKD 患者提供个性化饮食建议，以帮助保持肾小球滤过率并改善总体结果。