Further, for concordance across guidelines from various organizations that might facilitate policy decisions, Work Group members agree a target of <2.0 g per day should be recommended for CKD populations. Rationale This recommendation places a relatively higher value on studies in CKD populations demonstrating that short-term dietary sodium reduction interventions lower BP, and consistency with ndings of similar interventions in the general population. The recommendation also places a higher value on dietary sodium- reduction strategies as a readily available, non-pharmacologic intervention to lower BP in CKD populations. Relatively lower value was placed on the challenges in following a low-sodium diet in many current food environments. This recommenda- tion is made despite low-to-moderate-quality evidence in CKD populations per se, especially for hard clinical endpoints, because in the judgment of the Work Group, relative bene ts of efforts to lower dietary sodium intake will outweigh risks and healthcare costs in most patients. Although there is a lack of RCT data on use of potassium- containing salt substitutes in CKD populations, Work Group members are concerned about the risk of hyperkalemia that www.kidney-international.org chapter 2 these salt substitutes may pose to persons with advanced CKD, as well as observational data suggesting that higher dietary potassium intake may be associated with increased risk of CVand kidney outcomes in CKD populations.45,46 The Work Group acknowledges that there is also evidence to the contrary in people at high CV risk in the general popula- Therefore, the present recommendation for sodium reduction refers to dietary sodium reduction without substi- tution with potassium until further studies can discern risks and bene ts of salt-substitution strategies speci cally in CKD. Practice Point 2.1.1: Dietary sodium restriction is usually not appropriate for patients with sodium-wasting nephropathy. 