American Board of Internal Medicine (ABIM) Certification Practice Exam

What is considered an effective dietary sodium restriction for improving blood pressure control in advanced kidney disease?

1. Less than 1 g/d

2. Less than 2 g/d

3. Less than 3 g/d

4. Less than 4 g/d

The correct answer is: Less than 2 g/d

For individuals with advanced kidney disease, managing dietary sodium intake can play a significant role in controlling blood pressure and minimizing additional strain on the kidneys. A dietary sodium restriction of less than 2 grams per day is recognized as effective in contributing to better blood pressure management in this population. This threshold is beneficial because it balances the need to reduce sodium intake enough to lower blood pressure, while still being practical and sustainable for long-term dietary habits. Sodium restriction at this level has been associated with reduced fluid retention and hypertension, which are crucial considerations for patients with compromised kidney function. Restricting sodium intake any lower, such as to below 1 gram per day, might be unnecessarily stringent for many patients and could lead to nutritional deficiencies or other imbalances. High levels of sodium intake, above 2 grams per day, are more likely to exacerbate kidney disease complications and hypertension, highlighting the importance of maintaining a reasonable limit. Therefore, the recommendation of less than 2 grams per day is a targeted measure aimed at improving overall cardiovascular and renal health outcomes.