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low sodium diet; Na+ restriction

Restriction in Na+ intake, often in association with fluid restrictions. (also see dietary sodium) Indications: 1) renal failure 2) hypervolemia 3) congestive heart failure Contraindications: - low sodium diet may (< 3 g Na+ excretion/day) may be associated with increased cardiovascular risk (RR=1.3) in both hypertensive & normotensive individuals [3] - AHA critical of study [3] Clinical manifestations: - difficulty walking up two or three flights of stairs alone [4] Complications: - hyponatremia - increased risk of falls in the elderly [4] Notes: - no benefit of Na+ restriction even in patients with heart failure [1] - benefits of Na+ restriction in patients with heart failure may be unknown [2]

Related

dietary sodium; dietary Na+; dietary salt fluid (water) restriction

General

diet

References

  1. Taylor RS et al Reduced Dietary Salt for the Prevention of Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials (Cochrane Review) Am J Hypertens advance online publication, July 6, 2011 PMID: 21731062 http://www.nature.com/ajh/journal/vaop/ncurrent/abs/ajh2011115a.html http://www.nature.com/ajh/journal/vaop/ncurrent/full/ajh2011115a.html Alderman MH The Cochrane Review of Sodium and Health Am J Hypertens advance online publication, July 6, 2011 PMID: 21731063 http://www.nature.com/ajh/journal/vaop/ncurrent/full/ajh2011117a.html
  2. Doukky R et al. Impact of dietary sodium restriction on heart failure outcomes. JACC Heart Fail 2016 Jan; 4:24 PMID: 26738949 - Hummel SL, Konerman MC. Dietary sodium restriction in heart failure: A recommendation worth its salt? JACC Heart Fail 2016 Jan; 4:36 PMID: 26738950 - Yancy CW. The uncertainty of sodium restriction in heart failure: We can do better than this. JACC Heart Fail 2016 Jan; 4:39. PMID: 26738951
  3. Mente A et al Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. May 20, 2016 PMID: 27216139 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2930467-6/abstract - O'Brien E Salt - too much or too little? Lancet. May 20, 2016 PMID: 27216140 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2930510-4/abstract - American Heart Association strongly refutes study findings on sodium consumption. American Heart Association Comment. DALLAS, May 20, 2016 http://newsroom.heart.org/_c/573f94682cfac250e4422568/
  4. Lin YC, Yan HT Impact of dietary sodium restriction on falls among middle-aged and older adults: Results of an 8-year longitudinal study. Geriatr Gerontol Int. 2023 Sep 17. PMID: 37718504 https://onlinelibrary.wiley.com/doi/abs/10.1111/ggi.14669