Introduction
CKD, albuminuria
KIDNEY DISEASE, HYPERTENSION
Increased dietary salt intake is associated with high BP, cardiovascular risk, and mortality.There is a consensus that elevated salt intake is associated with increased BP and that this relationship is enhanced in people with hypertension.A 2021 Cochrane review and meta-analysis identified 21 studies in CKD and concluded that there was high-certainty evidence that lowering salt intake reduced both systolic and diastolic BP and albuminuria.Clinical trials designed to evaluate the benefit of lowering salt intake in CKD have deployed a range of intensive, personalized, and relatively expensive interventions to drive down salt intake during the study period.Kidney Disease: Improving Global Outcomes recommends a dietary salt intake of <5 g/d unless contraindicated.A clinician or person with CKD reviewing the available evidence and guidance could reasonably conclude that a reduction in salt intake is of benefit in CKD. However, it remains unclear how this recommendation can be converted into a real reduction in salt intake because there is a paucity of evidence about feasible and affordable interventions to help individual people with CKD achieve the salt reductions that are recommended. Therefore, it remains challenging for people to reduce their salt intake, especially if processed food is a major element of their diet.To address this evidence gap, we undertook a randomized controlled trial to test whether a simple low-cost intervention could help to empower people with CKD to reduce their dietary salt intake.