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Nephrol Dial Transplant (2002) 17: 1163-1165
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Dietary salt restriction and drug-free treatment of hypertension in ESRD patients: a largely abandoned therapy

Stanley Shaldon

Le Michelangelo, Avenue des Papalins, Monaco

The first 150 words of the full text of this article appear below.

‘Be not the first by whom the new are tried, nor yet the last to lay the old aside’ Alexander Pope, ‘Essay on Criticisms’ 1711

Historical reviews have a tendency to be dinosaurian and consequently, if read at all, have little impact upon therapeutic paradigms. However, the neglect of old knowledge may lead to therapeutic tragedies, and I believe that throughout the world today dialysis patients are being incorrectly managed with respect to dietary salt intake and the concentration of dialysate sodium to control hypertension. The word ‘salt’ is used in this article to mean sodium chloride. However, a ‘salt-restricted intake’ and a ‘dialysate sodium concentration’ refer to all sodium salts, including sodium bicarbonate.

The problem of poor control of hypertension in dialysis patients with the associated increase in mortality from cardiovascular causes has been recognized in the US by the National Kidney Foundation. It created a task force to . . . [Full Text of this Article]


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