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Progression of renal disease

High salt intake blunts the benefit of ACE inhibitors and accelerates renal function decline

Nature Reviews Nephrology volume 8, page 61 (2012)Cite this article

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High dietary salt intake seems to reduce the renoprotective effects of angiotensin-converting-enzyme (ACE) inhibitors and may increase the risk of progression to end-stage renal disease (ESRD), say investigators of a study recently published in the Journal of the American Society of Nephrology.

Inhibitors of the renin–angiotensin system effectively control high blood pressure and reduce proteinuria in patients with chronic kidney disease (CKD), but experimental data have shown that increased salt intake blunts the beneficial effects of this therapy. In addition, evidence from studies in humans suggests that high salt intake contributes to proteinuria and renal disease progression. “We designed this study to assess whether ACE inhibitors are effective in patients who eat large amounts of salt despite dietary recommendations to restrict salt intake, and whether the benefits of therapy are blunted by excessive salt intake,” explains investigator Piero Ruggenenti. To evaluate the association between salt intake, proteinuria and renal disease progression, 500 patients with CKD who received 5 mg ramipril daily in the Ramipril Efficacy in Nephropathy (REIN) and REIN-2 trials were included in this post hoc analysis.

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ORIGINAL RESEARCH PAPER

  1. Vegter, S. et al. Sodium intake, ACE inhibition, and progression to ESRD. J. Am. Soc. Nephrol. doi:10.1681/ASN.2011040430

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Authors
  1. Helene Myrvang
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Myrvang, H. High salt intake blunts the benefit of ACE inhibitors and accelerates renal function decline. Nat Rev Nephrol 8, 61 (2012). https://doi.org/10.1038/nrneph.2011.198

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  • DOI: https://doi.org/10.1038/nrneph.2011.198

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