Salt intake

Whatever the ideal daily salt intake in individuals with normal renal function, it is well established that for individuals with reduced renal function sodium overload occurs and is a strong factor for hypertension. In dialysis patients (whether hemo or peritoneal dialysis) out of the very few fortunate “salt-loosers” when they keep a residual renal function, there is a large evidence that restricting reasonably the salt intake (e.g 6g NaCl per day) is necessary to achieve a normal extracellular volume and blood pressure.

Hi y’all,

Dr. Charra has very kindly posted the previous message because the news story on the home page is about salt restriction being controversial for managing blood pressure–in healthy people.

In people who are on in-center hemo now, there is no question that salt must be limited. Salt causes thirst, which leads to fluid overload, which can damage the heart.

Is there a sodium restriction on SDD and SND as there is on 3x incenter dialysis?

Dr. Charra would be the one to ask but my understanding is that salt makes it harder to draw fluid off by keeping fluid in the tissues rather than in the blood stream where dialysis can remove it.

This is, I would guess, less of a problem for someone doing 8 hour runs because there is time for the fluid to migrate from the tissue into the blood stream but I would still lean towards reducing salt intake even I was dialyzing daily, nocturnal.

For short daily I do control sudium for three reasons: out of habit, as Dori said it helps control thirst and because it allows one to get dry without cramping. If I eat a salty meal for breakfast, I’ll be thirsty throughout the day, drink more fluid and then that evening I’ll try to remove the fluid by going down to my dry weight. However, because of that salt some of the fluid I try to remove that night may be in my tissues and when I try to take it off of already dry blood it could cause cramping. So yes, I still control salt but it isn’t very hard since my taste for salt changed long ago.

No sodium restriction on my side, been having all the salt I can have and still have normal blood pressure…the max fluid removal in one single treatment is only 1.2kg…on an average basis only between around .3 -.8 is taken off…

From my perspective, with nocturnal, I have to actively eat salt on my food or else I simply won’t gain enough fluid between the end of one treatment and the start of the next. There just isn’t enough time to gain that much. I’ve had to make an effort to even gain 1.5 kg in a day. Because nocturnal is so long, the amount to be removed is spread out over 7 or 8 hours, and so if you don’t gain enough, the UF rate will be below the minimum required by the machine to work properly. I know this has been discussed before and some people insist there is no limit, but the technical experts tell me there is.