The benefit of salt restriction in the treatment of end-stage renal disease by haemodialysis

被引:150
作者
Kayikcioglu, Meral [1 ]
Tumuklu, Murat [2 ]
Ozkahya, Mehmet [3 ]
Ozdogan, Oner [4 ]
Asci, Gulay [3 ]
Duman, Soner [3 ]
Toz, Huseyin [3 ]
Can, Levent H. [1 ]
Basci, Ali [3 ,5 ]
Ok, Ercan [3 ,5 ]
机构
[1] Ege Univ, Sch Med, Dept Cardiol, Izmir, Turkey
[2] Gazi Osmanpasa Univ, Sch Med, Dept Cardiol, Tokat, Turkey
[3] Ege Univ, Sch Med, Div Nephrol, Izmir, Turkey
[4] Izmir Tepecik Training & Res Hosp, Dept Cardiol, Izmir, Turkey
[5] FMC Clin, Izmir, Turkey
关键词
echocardiography; haemodialysis; hypertension; left ventricular hypertrophy; salt restriction; LEFT-VENTRICULAR HYPERTROPHY; LEFT ATRIAL VOLUME; DIALYSIS PATIENTS; CARDIOVASCULAR RISK; PERITONEAL-DIALYSIS; DIASTOLIC FUNCTION; HYPERTENSION; ECHOCARDIOGRAPHY; RECOMMENDATIONS; POPULATION;
D O I
10.1093/ndt/gfn599
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Most haemodialysis (HD) centres use anti-hypertensive drugs for the management of hypertension, whereas some centres apply dietary salt restriction strategy. In this retrospective cross-sectional study, we assessed the effectiveness and cardiac consequences of these two strategies. Methods. We enrolled all patients from two dialysis centres, who had been on a standard HD programme at the same centre for at least 1 year. All patients underwent echocardiographic evaluation. Clinical data were obtained from patients' charts. Centre A (n = 190) practiced 'salt restriction' strategy and Centre B (n = 204) practiced anti-hypertensive-based strategy. Salt restriction was defined as managing high blood pressure (BP) via lowering dry weight by strict salt restriction and insistent ultrafiltration without using anti-hypertensive drugs. Results. There was no difference regarding age, gender, diabetes, history of cardiovascular disease and efficiency of dialysis between centres. Antihypertensive drugs were used in 7% of the patients in Centre A and 42% in Centre B (P < 0.01); interdialytic weight gain was significantly lower in Centre A (2.29 +/- 0.83 kgversus 3.31 +/- 1.12 kg, P < 0.001). Mean systolic and diastolic blood pressures were similar in the two centres. However, Centre A had lower left ventricular (LV) mass (indexed for height(2.7): 59 +/- 16 versus 74 +/- 27 g/m(2.7), P < 0.0001). The frequency of LV hypertrophy was lower in Centre A (74% versus 88%, P < 0.001). Diastolic and systolic functions were better preserved in Centre A. Intradialytic hypotension (hypotensive episodes/100 patient sessions) was more frequent in Centre B (11 versus 27, P < 0.01). Conclusions. This cross-sectional study suggests that salt restriction and reduced prescription of antihypertensive drugs may limit LV hypertrophy, better preserve LV functions and reduce intradialytic hypotension in HD patients.
引用
收藏
页码:956 / 962
页数:7
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