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Beyond The Current Paradigm: Recent Advances in The Understanding of Sodium Handling – Guest Editors: Stanley Shaldon and Joerg Vienken: Salt, the Neglected Silent Killer


Address correspondence to: Prof. Dr. Ing. Joerg Vienken, BioScience Department, Fresenius Medical Care, ElseKroenerstrasse 1, D-61346 BadHomburg, Germany, or e-mail:


A diet high in salt (sodium chloride) is considered to promote a series of pathological sequaelae. Despite increasing scientific evidence, which supports the notion that reducing salt intake has positive long-term effects, citizens from the Western Hemisphere consume more, not less salt. Changes in lifestyle of modern societies associated with an increased consumption of “fast food” contribute to this development leading to the “disease of the good life” which involves hypertension, cardiovascular events, and even inflammatory effects. By contrast, consuming diets with reduced salt content are associated with a smaller shift of body fluids from the interstitial into the intravascular space, less antihypertensive medication, a reduced asymmetric dimethylarginine (ADMA) production and, after the generation TGFβ-mRNA, to a lower mitogen-activated protein kinases (MAPK) activation. Therefore, the recommendation of the clinical practice guidelines for dialysis [Depner et al. (14)] (as well as numerous other guidelines) to reduce salt intake is not a surprise.