Evidence map›Paper›PMID 26240299›Full record

SynthesisClinical journal of the American Society of Nephrology : CJASN2015

Meta-Analysis of the Effect of Dietary Sodium Restriction with or without Concomitant Renin-Angiotensin-Aldosterone System-Inhibiting Treatment on Albuminuria.

Lanfranco D'Elia, Giovanni Rossi, Michele Schiano di Cola, Ivana Savino, Ferruccio Galletti, Pasquale Strazzullo

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. "Minimal-Advice" on Salt Intake: Results of a Multicentre Pilot Randomised Controlled Trial on Hypertensive Patients.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025
    Trial
  7. Trial
  8. Dietary sodium restriction decreases urinary NGAL in older adults with moderately elevated systolic blood pressure free from chronic kidney disease.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2020
    Trial
  9. Trial
  10. Trial
  11. Trial
  12. Article
  13. Recommendations for pre-analytical urine sample handling to allow optimal assessment of albuminuria and proteinuria.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
  14. Salt and chronic kidney disease.Nature reviews. Nephrology · 2026
    Review
  15. Article
  16. Preserving renal function: gliflozins, GLP1 agonists, and antialdosterones.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  17. Can we slow down the decline in renal function?European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lanfranco D'EliaDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
Giovanni RossiDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
Michele Schiano di ColaDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
Ivana SavinoDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
Ferruccio GallettiDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
Pasquale StrazzulloDepartment of Clinical Medicine and Surgery, Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy strazzul@unina.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesUrinary albumin excretion and/or albumin to creatinine ratio are associated with CKD and higher risk of cardiovascular events. Several studies investigated the effect of reduced dietary sodium intake on urinary albumin excretion and/or albumin to creatinine ratio in adult patient populations, but the majority was inconclusive because of insufficient statistical power. A meta-analysis of the randomized, controlled trials available could overcome this problem and lead to more definitive conclusions. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A systematic search of the online databases available (from 1996 to October of 2014) was conducted of randomized, controlled trials that expressed urinary albumin excretion or albumin to creatinine ratio as the difference between the effects of two different sodium intake regimens. For each study, the mean difference and 95% confidence intervals were pooled using a random effect model. Heterogeneity, publication bias, subgroup, and meta-regression analyses were performed.

resultsEleven studies met the predefined inclusion criteria and provided 23 cohorts with 516 participants and 1-6 weeks of follow-up time. In the pooled analysis, an average reduction in sodium intake of 92 mmol/d was associated with a 32.1% (95% confidence interval, -44.3 to -18.8) reduction in urinary albumin excretion. The effect of sodium restriction was higher in the cohorts including patients on concomitant renin-angiotensin-aldosterone system-blocking therapy, in the studies with intervention lasting at least 2 weeks, and among participants with evidence of kidney damage. A greater reduction of urinary albumin excretion was associated with a higher decrease in BP during the intervention. The analysis of changes in albumin to creatinine ratio provided similar results.

conclusionsThis meta-analysis indicates that sodium intake reduction markedly reduces albumin excretion, more so during concomitant renin-angiotensin-aldosterone system-blocking therapy and among patients with kidney damage.

Indexed as

Diet, Sodium-RestrictedAlbuminuriaAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCreatinineHumansHypertensionRandomized Controlled Trials as TopicRenin-Angiotensin SystemSodium, DietaryAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCreatinineSodium, DietaryalbuminuriaBPkidney diseasenutritionrenin angiotensin system

Identifiers

PMID26240299
PMCPMC4559518

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.