Diabetes patients with renal disease: just a little less salt leads to huge health benefits

Even a modest reduction in the amount of salt that diabetes patients with renal disease ingest has very clear health benefits. As they tend to consume a higher than average amount of salt, the potential health benefits are vast. Reducing the salt intake of kidney patients with diabetes should therefore be made a priority. These are the findings of joint research carried out by nephrologists from the UMCG, Zorggroep Twente and the Medical Center Leeuwarden, which were published in today’s edition of the Lancet Diabetes & Endocrinology.

Diabetes is a major cause of renal disease. Treatment involves a change of diet as well as medication. Previous studies of patients with non-diabetic renal disease have already shown that drugs designed to protect renal function are ineffective if patients continue to consume too much salt. Although diabetes patients with renal diseases are made aware of the importance of diet, until now, little was known about the role of salt intake.

The DINAMO study involved monitoring the urine of a large group of diabetes patients with renal disease to ascertain how much salt they actually consumed. This turned out to be more than 12 grams/day, which is higher than the average salt intake in the Netherlands (7.5-8.5 g/d) and well above the 6 grams / day recommended by the Health Council of the Netherlands. A group of 45 patients then followed a salt-restricted diet for the next 6 weeks, reducing their salt intake to 8.7 grams/day. This not only lowered their blood pressure, but also led to a drop of more than 40% in urinary protein excretion. Similar results were obtained during a 6 week treatment period with diuretics (which remove salt from the body) but also the effect of diuretics was enhanced when they followed a restricted sodium diet as well.

According to Gerjan Navis from the UMCG, who is heading the research, these results show that extra attention should be paid to salt intake in kidney patients with diabetes. First, because it has been shown that this group consumes a higher than average amount of salt. According to Navis, this may be due to the focus on other elements of their diet. Secondly, because there is evidence that even a minor reduction in salt intake has huge health benefits for this group.

Read the publication: Lancet Diabetes Endocrinology