2002 Global Researcher Conference Proceeding
April 26 - 28, 2002
| Conference: | 2002 Global Researcher Conference |
|---|---|
| Title: | The Low Sodium Diet for Nephrogenic Diabetes Insipidus |
| Author: | Trahms, Cristine |
| Institution: | University of Washington |
One component of effective management of nephrogenic diabetes insipidus is the low sodium diet. Restricted sodium intake limits renal solute load and permits full effectiveness of chorothiazide. The usual sodium intake for persons in the US is about 5000 mg/day. From a medical perspective, the low sodium restriction for treatment of hypertension is 2400 mg/day.
The requirement for sodium varies with age: infants (‹1 year of age) require about 200 mg sodium, children (1 year to 10 years of age) require about 200-400 mg sodium, and children (older than age 10 years) and adults require about 500 mg sodium per day.
In western cultures it is undeniably difficult to restrict sodium to 500 mg on a daily basis. The restriction of sodium to 500 mg/day requires careful attention to the sodium content of all foods- fresh foods must be prepared without added salt, baked goods must be prepared with low sodium leavening, and commercially prepared products must be without sodium.
The consequences of inattention to sodium restriction vary with age. Infants with an unlimited sodium intake demonstrate poor growth, dehydration, and possible mental retardation. Children and adolescents with unrestricted sodium or insufficiently restricted sodium intake may demonstrate poor growth or excessive weight gain. Adults demonstrate bladder dilation, hydroureter, and hydronephrosis.
The goal of medical nutrition therapy for nephrogenic diabetes insipidus is to prevent the secondary effects of NDI and support normal growth and development. Typical infant and child development is supported by offering age appropriate formulas and foods -low sodium cereals, fruits, vegetables, teething biscuits- that provide both nourishment and enhance self-feeding skills. Children with NDI should learn self-management skills – reading labels, making appropriate food choices away from home, and basic food preparation skills. Adolescents and adults with NDI should have the skills to ‘live-life’. That is, skills to modify recipes and choose foods appropriately in social situations, self-care strategies that are appropriate in social and employment settings, and awareness of self-management resources and the skills to use them independently.
Recipe modification, menu planning, and cooking skills are essential to appropriate self-care. The basic concepts- elimination of salt and salty ingredients and addition of flavor enhancers, e.g., spices, lemon juice- render most home-prepared foods sufficiently low in sodium.