Dietary salt intake in chronic kidney disease: recent studies and their practical implications

Epidemiologic studies in the general population show that the level of dietary salt intake is associated with increases in blood pressure (BP), cardiovascular events, and mortality. According to trial data, reducing salt intake lowers the incidence of these 3 outcomes. On the basis of this evidence, the World Health Organization and other bodies recommend restricting salt intake. The association of salt intake with BP and cardiovascular disease has also been seen in chronic kidney disease (CKD), and trials of salt reduction in CKD have shown benefit, reflected by reduced BP and a lower rate of cardiovascular events. However, these trials have typically used resource‑intensive approaches to dietary salt reduction that are not suitable for routine clinical care, and salt intake typically remains high in people with CKD. The OxSalt care bundle is a low‑cost intervention that was demonstrated in the OxCKD1 trial to help people with CKD lower their salt intake, and could be applied in routine clinical practice.