Sodium Balance and Quality of Life in People with Chronic Kidney Disease-A Cross-Sectional Study

Background: Dietary sodium restriction in people with chronic kidney disease (CKD) may improve blood pressure and cardiovascular outcomes. However, little is known about body sodium levels (and dietary sodium restriction) on patient-reported health-related quality of life (HRQOL) in CKD. The primary aim of this study was to assess potential relationships between routinely used sodium measurements in clinical practice and acceptance of diet and fluid restrictions with HRQOL outcomes in people with CKD. Methods: We conducted a cross-sectional pilot study in 53 people with CKD, including those on dialysis, to explore relationships between HRQOL outcomes using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire and measures of dietary sodium intake and urinary sodium excretion. Results: Participants with low 24 h urinary sodium excretion reported poorer HRQOL in kidney-specific domains with lower KDQOL-36 component scores for effects of kidney disease (p = 0.03) and a trend towards lower scores in burden of kidney disease and symptoms of kidney disease (both p = 0.06). Those who had lower acceptance of fluid and diet restriction had poorer HRQOL in kidney-specific domains with lower KDQOL-36 component scores for burden of kidney disease and effects of kidney disease (all p ≤ 0.01). Conclusions: Low 24 h urinary sodium excretion and lower acceptance of fluid and diet restriction in people with CKD are associated with poorer HRQOL scores in domains that assess level of kidney disease interference with life. Further studies exploring underlying mechanisms between urinary sodium excretion and HRQOL in CKD are needed. Efforts to increase acceptance of diet and fluid restrictions in people with CKD may improve HRQOL outcomes.