Low-sodium diet

Description of Method. Salt substitutes, which are used in place of table salt for individuals on a low-sodium diet, contain KCI. Depending on the brand, fumaric acid, calcium hydrogen phosphate, or potassium tartrate also may be present. Typically, the concentration of sodium in a salt substitute is about 100 ppm. The concentration of sodium is easily determined by flame atomic emission. Because it is difficult to match the matrix of the standards to that of the sample, the analysis is accomplished by the method of standard additions. 

Cyclamate. Sodium cyclamate [139-05-9] (6), the sodium salt of cyclamic acid [100-88-9] was so widely used that it was often just called cyclamate. The other common salt, calcium cyclamate [139-06-0] is useful in low sodium diets. 

Ascites. Patients with cirrhosis, especially fiver cirrhosis, very often develop ascites, ie, accumulation of fluid in the peritoneal cavity. This is the final event resulting from the hemodynamic disturbances in the systemic and splanchnic circulations that lead to sodium and water retention. When therapy with a low sodium diet fails, the dmg of choice for the treatment of ascites is furosemide, a high ceiling (loop) diuretic, or spironolactone, an aldosterone receptor antagonist/potassium-sparing diuretic. 

Provide patient education in regard to the organ transplant, the complications associated with transplantation, the need for lifestyle modifications to reduce the risk of the complications (e.g., wear sunscreen, low-sodium diet), and drug therapy. 

Swelling of extremities Low-sodium diet Elevate feet... 

Rasilez contains aliskiren, which is a renin inhibitor used in hypertension as monotherapy or in combination with other antihypertensives. It is to be used with caution in patients taking concomitant diuretics, on a low-sodium diet or who are dehydrated and in patients with a glomerular filtration rate less than 30 mL/minute. Aliskiren may cause diarrhoea as a side-effect and it should be administered with or after food. It exists in two dosage strengths, 150 mg and 300 mg. 

Sodium content Sodium content of antacids may be significant. Patients with hypertension, CHF, marked renal failure, or those on restricted or low-sodium diets should use a low sodium preparation. 

Discovered in 1937 and patented in 1940, cyclamate is a derivative of cyclohexylamine, specifically, cyclohexane sulfonic acid. The sodium salt form is normally used, but the calcium salt may be substituted in low-sodium diets. See structural formulas below. 

These two elements are the main cations of the cell. Persons with high blood pressures are usually placed on a low sodium diet. Although potassium deficiency in normal adults is rare,... 

Asian-style sauces are high in salt and should be avoided by people on low-sodium diets. Seaweed... 

This can often be avoided by having the patient reduce sodium intake, thus decreasing sodium delivery to the K+-secreting collecting tubule. Patients who are noncompliant with a low sodium diet must take oral KC1 supplements or a potassium-sparing diuretic or must stop using the thiazide diuretic. 

Effective treatment of nephrotic edema requires adherence to a low-sodium diet (containing preferably only about 50 mmol of sodium per day) and administration of potent loop diuretics (e.g., furosemide), sometimes in high doses several times per day and/or in combination with thiazides and potassium-sparing diuretics (e.g., amiloride). Plasma ultrafiltration should be reserved for patients with refractory nephrotic edema and massive sodium and water retention. 

During the first 5 weeks, all animals are kept on a low sodium diet with tap water ad libitum. After stabilization of proteinuria (5 weeks), animals are divided into two groups receiving either low sodium or normal sodium diet. After a week of stabilization on these diets, animals may be treated with test componds. 

TABLE 10.8 Changes in Metabolites Occurring with Low-Sodium Diets... 

However, there are sometimes opportunities for withdrawal of furosemide (SEDA-22, 237). If diuretics are withdrawn suddenly in patients with a normal sodium intake, there will be rebound retention of sodium and water, because compensatory mechanisms that maintain sodium balance in the face of diuretics continue to act for several days after the diuresis has worn off. There are two methods of mitigating rebound retention of sodium and water gradual reduction of the dosage or institution of a low sodium diet so that only a small amount of sodium can be retained when the diuretic is withdrawn. Rebound retention of sodium and water, with consequent edema,... 

One of the earliest case reports was by Butler and colleagues who reported a patient in whom a low sodium diet (9 mEq/d) exacerbated renal dysfunction, increased urinary sodium loss, and caused postural hypotension [18]. Administration of supplemental oral sodium chloride promptly reversed the defect within 12 hours. These abnormalities were confirmed on rechallenge during treatment, but were absent 13 months after completion of AmB therapy. 

These findings are in accordance with Chua et al study in the volume depleted female Sprague-Dawley rat [106]. Rats were injected intramuscularly with five times the human dose of TMP-SMZ (100/500 mg/kg/ day) for nine days. Prior to treatment, the animals were placed in a low sodium diet for seven days and salt depleted by means of administration of furosemide (2 mg/kg/day) for the first three days. At baseline, experimental and control (glucose given instead of TMP-SMZ) groups have similar GFR, serum creatinine, and hematocrit and were conserving sodium maximally. Nine days of TMP-SMZ did not affect GFR, serum creatinine or electrolyte levels. Loss of body weight and anemia only developed in the rats treated with TMP-SMZ. In this study performed in female rats, known to have a lower tubular secretion of creatinine [107,108], TMP did not appear to decrease the tubular secretion of creatinine. 

Feldman RD, Lawton WJ, McArdle WL. Low sodium diet corrects the defect in lymphocyte B-adrenergic responsiveness in hypertensive subjects. J Clin Invest 1987 79 290-294. 

Houlihan CA, AUen TJ, Baxter AL, Panangiotopoulos S, Casley DJ, Cooper ME, et al. A low-sodium diet potentiates tlie effects of losartan in type 2 diabetes. Diabetes Care 2002 25 663-71. 

Concentrations of adrenal mineralocorticoids (e.g., aldosterone and DOC) and factors of the renin-angiotensin system (e.g., renin) are routinely measured in body fluids by various immunoassay and instrument-based methods. Aldosterone, like cortisol, is secreted episodically, with the highest circulating concentrations at about the time of awakening and the lowest concentrations shortly after sleep onset aldosterone concentrations, however, are only modestly stimulated by ACTH secretion.In healthy subjects, a low-sodium diet, maintaining an upright posture, and use of diuretics ail increase plasma aldosterone concentrations,... 

HypervitaminosisC. The vitamin is considered very safe. At one time, many of the over-the-counter products contained significant amounts of sodium ascorbate, which would be contraindicated in people on low sodium diets. Today s products are virtually sodium free unless labeled otherwise. Nevertheless, there are intermittent reports of adverse reactions associated with high doses. Therefore, there are Tolerable Upper Intake Levels, but these are very high relative to the RDAs. The UL to RDA ratio averages about 20. 

The initial effort in the treatment of DHF is aimed at decreasing symptoms. The first step in this effort is to decrease pulmonary congestion by decreasing LV volume using sodium and fluid restriction. A low-sodium diet (<2 g/day) and moderate fluid restriction will help to prevent volume overload. Both sodium and fluid restriction must be done with care. Excessive restriction can lead to hypotension, low-output state, and/or renal insufficiency. Daily weights may help to assess volume status. Dietary and lifestyle factors that decrease the risk of development of epicardial CAD and high blood pressure should be encouraged. 

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