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Anomalous role for dietary salt in diabetes mellitus?

Prevailing guidelines advocate a low-salt diet to mitigate progression of renal and cardiovascular disease in patients with diabetes mellitus. However, two recent cohort studies in patients with type 1 and type 2 diabetes mellitus associate lower salt intake with increased rates of end-stage renal disease, cardiovascular death and all-cause mortality.

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Figure 1: A conceptual framework that links low salt intake to end-stage renal disease and cardiovascular mortality via the salt paradox in the diabetic kidney—that is, an inverse relationship between salt intake and glomerular hyperfiltration.

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Acknowledgements

Work by the authors was supported by the NIH (R01DK56248, R01HL094728, P30DK079337), the American Heart Association (GRNT3440038) and the Department of Veterans Affairs.

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Correspondence to Volker Vallon.

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The authors declare no competing financial interests.

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Vallon, V., Thomson, S. Anomalous role for dietary salt in diabetes mellitus?. Nat Rev Endocrinol 7, 377–378 (2011). https://doi.org/10.1038/nrendo.2011.90

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