Dietary Sodium Reduction Reduces Albuminuria: A Cluster Randomized Trial

Meg J. Jardine, Nicole Li, Toshiharu Ninomiya, Xiangxian Feng, Jianxin Zhang, Jingpu Shi, Yuhong Zhang, Ruijuan Zhang, Jing Zhang, Jesse Hao, Vlado Perkovic, Hiddo L. Heerspink, Yangfeng Wu, Lijing L. Yan, Bruce Neal

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Objectives: The objective of the study was to assess the impact of sustained dietary salt reduction on albuminuria in nearly 2000 community-dwelling adults. Design and Methods: The present study is a prespecified secondary analysis of the China Rural Health Initiative Salt Reduction Study cluster randomized trial undertaken in 120 villages in rural China. Villages were randomized to a sodium reduction program of education and access to reduced-sodium salt substitute or control. Urinary albumin-to-creatinine ratio (uACR) and albuminuria (uACR ≥22.1 or 31.0 mg/g for men and women, respectively) were assessed at 18 months in a stratified random sample of predominantly older individuals living in participating rural villages. Results: A total of 2,566 participants from 119 villages provided 1,903 eligible urine samples. The sodium reduction program reduced sodium intake by an equivalent of 0.82g of salt/day (0.06-1.68 g) (322 [24-661] mg sodium/day). The mean uACR was 8.85 (8.05-9.82) mg/g (1.00 [0.91-1.11] mg/mmol) in intervention participants compared with 10.53 (9.73-11.33) mg/g (1.19 [1.10-1.28] mg/mmol) in control participants (p=0.008). The corresponding odds ratio for albuminuria was 0.67 (0.46-0.99). Conclusions: Dietary sodium reduction was associated with significantly lower uACR and less albuminuria after 18 months. Whether CKD progression can be slowed by dietary sodium reduction should be a global research priority. NCT01259700.

Original languageEnglish
Pages (from-to)276-284
Number of pages9
JournalJournal of Renal Nutrition
Issue number4
Publication statusPublished - Jul 2019

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology


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