WASHINGTON—Lowering salt intake may help reduce fluid build-up in kidney patients and be more effective in reducing high blood pressure than antihypertensive medications, according to an analysis appeasing online May 27 in the Clinical Journal of the American Society Nephrology (CJASN).
Dry-weight is a kidney disease patient’s weight immediately after dialysis, when he or she does not carry the excess fluid that builds up between dialysis treatments. Dry-weight is the lowest weight one can safely reach after dialysis without developing symptoms of low blood pressure such as cramping, which can occur when too much fluid is removed. If a patient lets too much fluid build up between sessions, it is harder to get down to a proper dry-weight.
Achieving and maintaining dry-weight can improve blood pressure between dialysis sessions and limit hospitalizations. This appears to be an effective but forgotten strategy in controlling and maintaining blood pressure control among hypertensive patients on dialysis.
Researchers found that dry-weight can be assessed inexpensively through relative plasma volume monitoring (which uses photo-optical technology to assess changes in volume of a patient’s blood) and body impedance analysis (which determines lean body mass).
They also discovered that restricting salt intake can help control blood pressure and make it easier for patients to get down to a proper dry-weight. Studies suggest that salt restriction and dry-weight reduction through dialysis together provide more benefits to the heart than antihypertensive medications. This could have important clinical implications because most patients with chronic kidney disease die from cardiovascular causes.
