with chronic kidney disease are recommended low salt diets, i.e. less than a teaspoon of salt per day (which is <5-6g of salt, which contains <2-2.3g of sodium). The average intake in the general population is double the recommended intake, between 1-2 teaspoons per day, which is considered ‘moderate’ intake. In patients with hypertension, reducing from moderate (average) to low intake is associated with a small reduction in blood pressure. However, achieving this low target salt intake is difficult, and can have a negative knock-on effect on other healthy dietary factors and kidney hormones. In addition, there is no convincing research to show that patients with chronic kidney disease and normal blood pressure benefit from low salt intake. In fact, the small amount of research that does exist shows that the change in kidney function is the same in people who consume low salt diets (<1 teaspoon) and moderate (1-2 teaspoons=average intake) salt diets. Moreover, there are some small studies that report that low-salt diets may increase the risk of death due to heart disease. Given that all patients with chronic kidney impairment are recommended a low-salt diet, it is important that we confirm that this recommendation truly benefits patients. In this randomized controlled trial (the first to address this question), we determine whether recommending a low salt intake, compared to average/moderate intake, is associated with a slower rate of decline in kidney function in patients with chronic kidney impairment. The results of this study will provide information to guide future research, that will have critical implications for management of patients with chronic kidney disease. 20. Title Genetic basis of reflux nephropathy-related hypertension and renal failure in children Principal Investigator Professor David Barton, The Childrens' Medical and Research Foundation Lay Summary Vesicoureteric reflux (VUR) is the backflow of urine from the bladder towards the kidneys. It is a common disorder in children, but is often not diagnosed because it may have no symptoms. In some children, it stops happening as they grow, and they suffer no ill effects. However, it can be associated with kidney damage, and is a major cause of high blood pressure and of kidney failure in children. It is more common in children who have repeated urine infections, and that is when it is usually detected. It can be treated by endoscopic surgery, and this usually stops the urine backflow from happening, but sadly it often does not prevent kidney failure from developing, so we need to understand why this is. VUR runs in families, and more than 250 Irish families have volunteered to help us to find the causes by donating blood samples so that we can study their DNA. The inheritance of VUR is proving to be very complicated, and we are amongst a number of laboratories in different countries working on the problem. New technologies for testing DNA for common variations, and for reading DNA sequences to find new variations, are starting to make a big difference to the rate at which we can find answers, but there is still a lot more to do to find which variations cause VUR, and then we still have to find out HRB Health Research Awards 2014 – Full list: Page 12 of 21
how they cause it. The aim is that eventually we shall be able to predict which children will grow out of their VUR
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- Summer '07
- The Giver, Universal health care, Health Research Awards