E-Kidney | June 2012

Shake the Salt Habit

Blood Pressure Best Managed When Healthy Lifestyle is Central to Treatment

Top 5New approaches to controlling blood pressure are on the horizon, but one of the most powerful steps patients can take is to improve their lifestyle, particularly by reducing salt intake. According to experts who presented during the 2012 National Kidney Foundation Spring Clinical Meeting, shaking the salt habit and making other healthy lifestyle changes such as quitting smoking and exercising can have a big impact on blood pressure control in people with chronic kidney disease (CKD).

Controlling blood pressure is a major issue for people with CKD, most of whom exceed recommended targets putting them at higher risk of kidney failure, says George Bakris, MD, member of the National Kidney Foundation board of directors and a professor of medicine and director of the ASH Comprehensive Hypertension Center at The University of Chicago Medicine.

"It's an exciting time in blood pressure management," adds Dr. Bakris, "We have some really promising new techniques to lower blood pressure in kidney disease that are being investigated as we speak."

Alongside these new techniques, Dr. Bakris says doctors need to do a better job of educating patients about the importance of reducing salt intake. "Doctors can prescribe as much medication as they like, but if patients continue to eat a high salt diet, their blood pressure will never be fully controlled," he says.

During the session, Dr. Bakris and his colleagues described a new technique to control blood pressure known as renal denervation. It's already approved in Europe and Australia, but won't be in the U.S. for at least another 18 months. As part of the technique, doctors deactivate the nerves that send signals to the kidney, heart, and brain in response to changes in blood pressure. Although not all patients experience decreases in blood pressure immediately following surgery, within three years, most see improvements, explains Dr. Bakris. "We don't know exactly why it works, but it does."

Another new implantable device stimulates little neural bundles in the neck that help regulate blood pressure. This device is likely further away from general usage, but also holds exciting promise, said Dr. Bakris.

"The overall evidence suggests that both new approaches can safely reduce blood pressure in patients with resistant hypertension," says Dr. Bakris. "Both work, but by different mechanisms, in different parts of the body."

For more information about high blood pressure and the kidneys, visit the National Kidney Foundation at www.kidney.org.