1. Is sodium an old enemy or a new friend?
을지대학병원 신장내과
방기태

2. A meta-analysis of data from randomized, controlled trials (RCTs) has demonstrated
we do not currently have strong evidence to indicate that there is a beneficial effect of salt restriction on mortality
It might, in fact, increase the risk of all-cause mortality in patients with heart failure (HF).

3. “to reduce their dietary salt intake shows a beneficial effect in the short term (up to 3 years) in reducing blood pressure by a small amount (1–4 mmHg),
but no strong evidence of a reduction in deaths,”
currently available RCTs are still not good enough ... for any conclusion on the general health impact of salt reduction.”

4. Objective: To assess whether 24-hour urinary sodium excretion predicts blood pressure(BP) and health outcomes.
Participants : 3681 participants without CVD

6. the study as being small with low event rates and relatively young participants.
unreliable measurement of sodium intake
failure to account for key factors that influence sodium intake and heart disease risk, and missing or incomplete urine data

7. 세계 최대의 소금호수 볼리비아 우유니 소금 사막

8. Universal sodium restriction
Pros (For)
Almost all the Associations
National High Blood Pressure
Education Program (NHBPEP)
Almost all the doctors
Cons (Against)
Salt Institute(USA)
David A McCarron**
Michael H Alderman^^

16. This single-center retrospective cohort study enrolled 305 incident patients who started peritoneal dialysis in our unit from July 2002 to February 2007.

19. 24 hour urine collections 7354 men and women aged 40-59 selected at random
Urinary Na??

20. ^^
Baseline information during 1971–75 in a representative sample of US adults (aged 25–75)
underwent medical examination and nutritional examination based on 24 h recall.

21. ^^

22. ^^
Representative sample (n=8,699) of non-institutionalized US adults age ≥30, without history of CVD events, recruited between 1988–1994.
Dietary sodium and calorie intake estimated from a single baseline 24-h dietary recall.

23. ^^

25. A DASH OF DATA IN THE SALT DEBATE
Science (New York, N.Y.) [Science] 2000 May 26; Vol. 288 (5470), pp
DASH-Sodium
David McCarron**, of the Oregon Health Sciences University in Portland,
for those with normal blood pressure eating the healthy DASH diet, reducing salt from 8 grams to 4 grams a day made little difference in blood pressure (1.7/1.1 mmHg).
If you are eating the healthy DASH diet and you have normal blood pressure, sodium restriction has almost no effect.

27. Professor Fujita
until we have more-robust data, “we should not change [recommendations for] salt restriction to less than 6 g per day as a life-style modification in hypertension guidelines.”

28. 경청해주셔서 감사합니다.