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NDT Advance Access originally published online on February 19, 2004
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Nephrol Dial Transplant (2004) 19: 1046-1049
Nephrol Dial Transplant Vol. 19 No. 5 © ERA-EDTA 2004; all rights reserved

Editorial Comment

Sodium, blood pressure and cardiovascular pathology: is it all volaemia?

Jeroen P. Kooman, Frank M. van der Sande and Karel M. L. Leunissen

Department of Internal Medicine/Nephrology, University Hospital Maastricht, Maastricht, The Netherlands

Correspondence and offprint requests to: J. P. Kooman, Department of Internal Medicine/Nephrology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Email: jkoo@sint.azm.nl

Keywords: dialysis; hypertension; nitric oxide; oxidative stress; renal failure; sodium

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



   Introduction
 
The daily intake of salt in the western world greatly exceeds human needs, which may have adverse cardiovascular consequences, especially in patients with abnormalities in renal sodium handling. In normotensive subjects, the effects of salt intake on blood pressure appear to be relatively small [1]. However, a large subset of patients with essential hypertension responds to salt loading and restriction with pronounced changes in blood pressure, which has led to the concept of salt sensitivity [2].

Patients with end-stage renal disease are very susceptible to the adverse effects of salt, as their ability to excrete sodium is lost or greatly impaired. In these patients, sodium loading may lead to severe hypertension and left ventricular hypertrophy. It is generally accepted that in renal patients, the adverse effects of salt are predominantly due to a combined water and sodium overload due to the fact that the body tries . . . [Full Text of this Article]



   The salt sensitivity concept
 


   Salt and blood pressure in patients with renal disease
 


   Does sodium influence structural modifications on the cardiovascular system, independent of blood pressure?
 


   How are the trophic effects of sodium mediated?
 


   Summary
 

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Revisiting the Dialysate Sodium Prescription as a Tool for Better Blood Pressure and Interdialytic Weight Gain Management in Hemodialysis Patients
Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 522 - 530.
[Abstract] [Full Text] [PDF]