The relationship between salt intake and blood pressure in hypertensive patients with chronic renal failure with quality of life, anxiety and depression levels

Introduction and Aim: Dietary sodium restriction has become common practice for chronic renal failure, but the importance of restriction is often overlooked. In patients with chronic renal failure, the inability of the kidneys to excrete sodium is the main cause of hypertension and can lead to progression of the disease. Hypertension is a slowly progressing and insidious disease that progressively damages the kidney, one of the target organs; an important component of treatment is the reduction of salt intake. In our study, we investigated the relationship between salt intake and blood pressure values of hypertensive patients with chronic renal failure and how it affects the person's quality of life (QoL), anxiety and mood. Materials and Methods: 140 patients with chronic renal failure and hypertension who applied to the nephrology clinic for treatment or control were included in the study. During routine check-ups, the patient's 24-hour urinary sodium excretion and blood pressure at the time of examination were measured, and the SF-36 and HAD scales were used to determine quality of life and anxiety and depression levels, respectively. Results: Depression was detected in 40.7% of the patients and anxiety in 16.4% of the patients with the HAD scale. There was a significant correlation between blood pressure control and SF-36 physical function score (p:0.025), SF-36 social function score (p:0.007) and SF-36 pain score (p:0.012). A statistically significant correlation was found between salt consumption and blood pressure (p<0.01). In patients whose blood pressure was not under control, a significant difference was found in the increase in the risk of depression compared to the high or low salt intake (p:0.08). A statistically significant difference was found between the amount of salt intake and the SF-36 social function score in the group whose blood pressure was not under control (p:0.03). SF-36 social function score was found to be significantly lower (p:0.032) in patients undergoing dialysis. Likewise, SF-36 role difficulty physical score (p:0.002) and SF-36 role difficulty emotional score (p:0.012) were also statistically significant. Conclusion: The most important step in the treatment of hypertension, which is both the cause and the result of CKD, is the restriction of salt. Although quality of life scores are higher in patients with controlled blood pressure, the same is not true for anxiety and depression. In our literature review, it is thought that it is the first study in this field, as there is no similar study showing in which direction and how blood pressure will be affected simultaneously with the amount of salt intake in patients diagnosed with CKD and hypertension, and how this effect is related to quality of life, anxiety and depression. Keywords: Chronic Renal Failure, Hypertension, Salt, Anxiety, Depression, Quality of Life, HAD, SF-36