An explanation for the 'lagphenomenon' in drug-free control of hypertension by dietary salt restriction in patients with chronic kidney disease on hemodialysis

摘要

Over 40 years ago, we published our initial studies on the dramatic results that were obtainable using dietary salt restriction to treat hypertension in anuric patients with end-stage renal disease receiving maintenance hemodialysis. I had been schooled in the benefits of salt restriction when I had worked with Sheila Sherlock treating patients with cirrhosis and ascites. I was already familiar with Walter Kempner's original success with a rice diet in controlling hypertension hi patients with chronic renal failure [Kempner 1944] and also the success that Belding Scribner [ 1960] had achieved in Seattle with his original patients. As our results were so dramatic, I have always preached the need for salt restriction in patients with chronic kidney disease. We were always impressed that the real benefit occurred several months after the patient had reached "dry body weight" [Comty et al. 1964].