NDT Advance Access originally published online on February 14, 2008
Nephrology Dialysis Transplantation 2008 23(5):1779; doi:10.1093/ndt/gfn046
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Negative outcome studies in end-stage renal disease: how dark are the storm clouds?
Correspondence and offprint requests to: E-mail: stanley.shaldon{at}libello.comSir,
It is incredible that in 2008, an editorial review by such learned gentlemen as Covic and Goldsmith fails to discuss the ‘salt factor’ in their gloomy attitude towards the prognosis of ESRD patients [1]. It is even more astonishing that this omission occurred after KDOQI guidelines revised their advice on salt intake and recommended a salt-restricted intake for all CKD patients [2]. Clearly, they are not aware of the outstanding reductions in CVD and mortality reported by Nancy Cook in a 10-year follow-up of prehypertensive, but otherwise normal, population maintained on a low-salt diet [3]. Finally, they do not cite the two centres that have reported the best long-term survival data on dialysis in the world; both have employed obsessive salt restriction as a main part of their programme [4,5]. Even given the long gestation period of the review and its revision, one must question whether the review process was adequate for this editorial comment to see the light of day. One must conclude that, given their extensive conflict of interest declarations, there can be little commercial benefit from recommending a low-salt diet.
Conflict of interest statement. None declared.
Department of Nephrology, University Hospital of Nimes, Fontvielle, Monaco
References
- Covic A, Gusbeth-Tatomir P, Goldsmith D. Negative outcome studies in end-stage renal disease: how dark are the storm clouds? Nephrol Dial Transplant (2008) 23:56–61.
[Free Full Text] - K/DOQI. Clinical practice guidelines for hemodialysis adequacy update 2006. Guideline 5: on control of volume and blood pressure. Am J Kidney Dis (2006) 48(Suppl_1):s33.
- Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ (2007) 334:885–888.
[Abstract/Free Full Text] - Charra B, Calemard E, Ruffet M, et al. Survival as an index of adequacy of dialysis. Kidney Int (1992) 41:1286–1291.[Web of Science][Medline]
- Ozkahya M, Ok E, Toz H, et al. Long-term survival rates in haemodialysis patients treated with strict volume control. Nephrol Dial Transplant (2006) 21:3506–3513.
[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||