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논문분류	춘계학술대회 초록집
제목	Low Salt Diet Increase Estimated net Endogenous Acid Production in Non-diabetic CKD Patients Treated with Angiotensin Receptor Blockade
저자	Seon Ha Baek1, Sejoong Kim1, Dong Ki Kim2, Jung Hwan Park4, Sung Joon Shin5,Sang Ho Lee3, Bum Soon Choi6, Ho Jun Chin1, Suhnggwon Kim2, Chun Soo Lim7
출판정보	2014; 2014(1):
키워드	대사성 산증, 저염식, ARB
초록	Background: High net endogenous acid production (NEAP) levels precede renal disease progression in patients with chronic kidney disease (CKD). Angiotensin receptor blockade (ARB) exacerbates metabolic acidosis by inducing a distal- tubular acidification defect. Little is known about the acid-base effects of LSD on patients treated with ARB. We therefore evaluated the effect of LSD on NEAP in non-diabetic patients with CKD treated with ARB. Methods: A total of 205 adult subjects were enrolled in the present study from the original trial (ESPECIAL trial: NCT01552954). Non-diabetic CKD patients were divided into LSD and non-LSD groups and were treated with olmesartan for 8 weeks. Results: During the interventional 8 weeks, NEAP in the LSD group was much increased, compared with control group (12.9±32.0 versus -2.0±35.0, p=0.002). NEAP was positively associated with LSD after adjusting for age, serum creatinine, sodium, bicarbonate, uric acid, 24-hour urinary creatinine excretion, previous randomization (r=.23, p=0.001). A decrement of 1g/d of salt intake predicted an increment of 1.75 mEq/d in NEAP (P=0.008). Additional reduction of 2.39 g/d of protein intake with the reduction of 1g/d of salt intake cannot increase NEAP under the treatment of ARB and LSD. Conclusion: We found that LSD may increase NEAP in non-diabetic CKD patients using ARB, which suggests that additional dietary protein restriction should be required for maintaining NEAP in non-diabetic CKD patients with ARB and LSD.
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