Factors impacting sodium restriction in patients with chronic kidney disease: a cohort study from a Chinese center

Sodium restriction is important for the management of chronic kidney disease (CKD). The present study evaluated the factors impacting dietary sodium restriction in a cohort of Chinese patients with CKD.

A questionnaire on dietary sodium restriction was administered to patients with non-dialysis CKD who visited our CKD clinic from September 2014 to March 2015. Twenty-four-hour urinary sodium excretion (24-h UNa) was measured. Logistic regression was performed to examine the association between patient characteristics and sodium restriction.

Two hundred and twenty-nine patients were included in the final analysis. Most of the patients (97.7 %) declared their awareness of the necessity of sodium restriction, but 27.3 % of them chose an incorrect sodium restriction limit. Most of the patients (85.2 %) also reported that they had taken actions to reduce their sodium consumption, with intolerance of sodium restriction as the most common reason for taking no actions. Only 42 patients (18.3 %) had a 24-h UNa of <100 mmol. Multivariable logistic regression showed that age and the use of condiments were independently associated with successful sodium restriction [odds ratio (95 % confidence interval) 1.04 (1.01-1.07), p = 0.006 and 0.38 (0.16-0.88), p = 0.023, respectively]. Most of the patients (83.0 %) did not know how to estimate their sodium intake from condiments.

This study indicates that there is much room for improvement in dietary sodium restriction in Chinese patients with CKD. Condiments as a hidden source of sodium intake should be stressed in the education of these patients.