Salt Triggers Changes in Heart Structure Among Chronic Kidney Disease Patients

A research team from the University of Erlangen-Nuremberg provide insights into the causes for change in the heart’s structure among people with chronic kidney disease (CKD). This study, which was published in the Journal of the American Society of Nephrology (JASN) has identified a treatment for this condition that could lie in the level of sodium in the skin. Increased sodium was found to affect the heart health of chronic kidney disease patients. Patients with chronic kidney disease are at an increased risk of developing heart problems and dying due to cardiac problems. The higher risk for cardiac problems can be attributed, to a certain extent, to the existence and severity of left ventricular hypertrophy (LVH). This condition is characterized by the enlargement and thickening of the heart’s left ventricular walls. Though the reason behind the development of left ventricular hypertrophy is unknown, earlier studies have found that it could be associated with the intake of sodium.

Sodium in the Body

Studies that were conducted in the recent past have shown that skin, muscle and certain other tissues store sodium. Dr. Markus Schneider from the University of Erlangen-Nuremberg and his colleagues wanted to identify if the sodium levels in these newly diagnosed places of sodium deposition were associated with the severity of left ventricular hypertrophy in patients with chronic kidney disease.

Measuring Skin Sodium Levels

About 99 patients with mild to moderate chronic kidney disease were included in the study and the research team used 23Na-magnetic resonance imaging for measuring the level of sodium content in the calf skin. Other parameters that were measured include blood pressure over a period of 24 hours, the total body water level and the left ventricular mass.

The study found that

• The content of sodium in the skin correlated with systolic blood pressure
• The total body water content did not correlate with systolic blood pressure
• There was a stronger correlation between skin sodium and left ventricular mass than total body water
• Further analysis showed that the sodium levels in the skin were a strong variable linked to the left ventricular mass, irrespective of the total body water or the blood pressure

Dr. Schneider said that the research team believed that skin sodium is a reflection of the excess deposition of sodium in the body. The study findings are indicative of a strong relationship between the sodium in the skin and changes that occur in the structure of the heart. Interventional strategies that are aimed at reducing the level of sodium in the skin could benefit the heart in patients with kidney disease through

• Dietary sodium restriction
• Medications which increases sodium excretion

Salt and Its effect on Blood Pressure

The amount of salt that is consumed is directly associated with blood pressure. Salt makes the body hold onto water and, in the event of an excess salt consumption; the additional water that is stored in the body requires the heart to pump more, raising blood pressure levels. Therefore, the higher the intake of salt, the higher the blood pressure of the individual.

An increase in the blood pressure, in turn, adds to the strain on the arteries, heart, brain and the kidneys. This could result in strokes, dementia, heart attacks and kidney disease. Excess intake of salt could medications for blood pressure and diuretics ineffective.

Effect of Salt on the Arteries

The increase in blood pressure that is caused due to excess consumption of salt adds to the strain on the inner walls of the arteries. To make up for this strain, the artery walls become thicker and stronger. This results in reduced space of the artery walls.

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The increase in blood pressure and the decrease in the space within the arteries could clog the artery and prevent blood flow or it could lead to the artery bursting, in rare cases. This would lower the blood supply to the organs to which the artery was supplying blood and the organs would be devoid of nutrients and oxygen. This is a potentially fatal condition.

Restricting the salt intake in the body is, therefore, an important criterion for lowering the risk for cardiac problems and changes in the structure of the heart of chronic disease patients.

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References:

1. Salt's effects on your body - (http://www.bloodpressureuk.org/microsites/salt/Home/Whysaltisbad/Saltseffects)

Source-Medindia