The effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis patients / 中华内科杂志

ABSTRACT

Objective To evaluate the effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis (CGN) patients. Methods From October 2007 to April 2009, 32 CGN inpatients were enrolled. Among them, 15 patients followed a strict dietary salt restriction menu (sodium 100 mmol/d, potassium 50 mmol/d, protein (0. 8-1. 0) g · kg~(-1) · d~(-1) , calorie (105-125) KJ · kg~(-1) · d~(-1) ) for 7 days, while the other 17 patients were fed freely offered by hospital as controls. 24 h urinary sodium excretion (24h-UNa) was used to monitor the salt intake. No changes of drug therapy were made during the study. Blood pressure was monitored every day. 24-hour urinary protein and serum biochemical parameter were measured before and after the study. Results There was no significant difference of baseline 24h-UNa between the two groups [(135.1 ±50.4) mmol/d vs (137.4 ±28.6) mmol/d) ]. During the study, the average 24h-UNa of patients with strict dietary intervention was (97. 2 ± 8.6) mmol/d. Both SBP [ (117. 7 ± 10. 0) mm Hg( 1 mm Hg=0. 133 kPa) vs (106.2 ±9.9) mm Hg] and DBP [ (76. 3 ± 6. 1 ) mm Hg vs (67. 5 ± 5. 5 ) mm Hg] decreased significantly ( P < 0. 001 ) . Proteinuria decreased significantly too [ 1. 57 (0. 3-3. 0) g/d vs 0. 57 (0. 16-2. 72) g/d,P = 0. 006]. The reduction of SBP was positively correlated with the reduction of 24h-UNa (r =0. 572, P =0. 026) , while the reduction of proteinuria correlated with both the reduction of SBP (r = 0. 568, P = 0. 027) and 24h-UNa (r =0. 525, P =0. 044). In the control group, only SBP decreased significantly [ ( 122. 6 ± 15. 5) mm Hg vs (115.8 ±10.4) mm Hg, P = 0.02] without significant changes of DBP and proteinuria When comparing the subgroups who took ACEI/ARB from both groups, the reduction of proteinuria wasmore prominent of those from the study group than the control group [ - 0. 4 ( -0. 95-0. 07) vs 0. 07 ( - 0. 39-0. 42), P = 0. 014 ]. Conclusion Strict dietary salt restriction is effective in reducing blood pressure and proteinuria in CGN patients.