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Kidney Int:高血压“低钠”原则要被推翻?

2018-04-16 吴星 环球医学

高钠摄入对健康的危害几乎是人尽皆知,高血压患者更是谈钠色变。但低钠就一定有益健康吗?钠摄入是越少越好吗?2018年4月,韩国科学家在《Kidney Int》发表了一项研究,在肾功能正常患者的前瞻性队列中,评估了钠的摄入对慢性肾病(CKD)进展的影响。

高钠摄入对健康的危害几乎是人尽皆知,高血压患者更是谈钠色变。但低钠就一定有益健康吗?钠摄入是越少越好吗?2018年4月,韩国科学家在《Kidney Int》发表了一项研究,在肾功能正常患者的前瞻性队列中,评估了钠的摄入对慢性肾病(CKD)进展的影响。

这是一项前瞻性、基于社区的队列研究,从韩国基因组和流行病学研究中获取数据。通过24小时膳食回忆食物频率问卷评估钠的摄入。

研究者共分析了3106例高血压和4871例非高血压患者,首要终点为CKD进展[随访期估计肾小球滤过率(eGFR)低于60mL/min/1.73m2和/或发生蛋白尿的复合]。

高血压和非高血压患者的中位年龄分别为55岁和47岁,男性比例分别为50.9%和46.3%,中位eGFR分别为92和96mL/min/1.73m2。

在高血压患者中位随访123个月和非高血压患者中位随访140个月期间,分别有27.8%和16.5%的患者进展CKD。

校正混杂因素后,多元Cox模型显示,钠摄入少于2.08g/天或超过4.03g/天的高血压患者,进展CKD的风险显著高于钠摄入2.93~4.03g/天的患者。然而,非高血压患者的每四分位数,CKD风险无显著差异。

作者认为,高和低钠摄入均与CKD风险增加相关,但是仅在高血压患者中观察到此相关性。

本研究在肾功能正常的受试者中,考察了膳食钠摄入与CKD进展之间的相关性。在高血压患者中,高和低膳食钠摄入均显著增加CKD风险。然而,钠摄入量不影响非高血压患者的CKD进展。这些结果表明,均衡的膳食钠摄入有助于保护肾功能,并且这种效应取决于血压状态。

古语说,物极必反,凡事要懂得适度!钠摄入也是如此,过高过低钠摄入均危害健康,显著增加高血压患者的CKD进展风险。高血压患者过度忌盐不可取。

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    2022-03-06 云舒

    学习了

    0

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    2018-04-18 zz12341238
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    2018-04-18 gwc389
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    2018-04-17 张新亮1853311252142e2fm

    好文献.学习了

    0

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    2018-04-17 秀红

    学习了

    0

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