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Chronic kidney disease affects 26 million people in the United States.

Challenging prevailing wisdom that only children with end-stage kidney disease suffer physical, social, emotional and educational setbacks from their disease, research led by Johns Hopkins Children's Center shows that even mild to moderate kidney disease may seriously diminish a child's quality of life.

The findings, reported in the February issue of Pediatrics, suggest that earlier attention to quality-of-life issues in children with chronic kidney disease is needed.

"Even mild and moderate declines in kidney function may lead to serious physical, emotional, intellectual and social challenges," says lead investigator Arlene Gerson, Ph.D., a pediatric psychologist at Hopkins Children's.

Kidney Disease Screening is Needed

"What this means is we should be thinking about screening children for these challenges and intervening earlier than we once thought."

Recently diagnosed children who report learning problems may benefit from help before grades drop, researchers say, noting that children with chronic diseases currently do not qualify for special education until their scores decline dramatically.

Links Between Kidney Function and Quality of Life

In their study of 402 children, ages 2 to 16, with mild-to-moderate kidney disease, researchers analyzed the link between kidney function, disease severity, age of onset and disease duration, on the one hand, and physical, emotional, psychological and school functioning on the other.

The researchers also compared quality-of-life outcomes between healthy children and children with early-stage kidney disease. Children with mild-to-moderate kidney disease and their parents reported worse overall outcomes on standard quality-of-life questionnaires and worse outcomes on all quality-of-life factors.

Specifically, children with early-stage kidney disease scored on average 75 out of 100 on quality-of-life measures, compared to 83 out of 100 for healthy children. The difference was especially pronounced in school functioning, where children with early-stage kidney disease scored 64 out 100, compared to 80 out of 100 for healthy children.

How Children Cope with Kidney Disease

The study also found that the younger the child at the time of the diagnosis and the longer the child lived with kidney disease, the better the overall quality of life, a surprising finding, suggesting that as time passes children learn to cope better with their condition, the researchers say.

The researchers found that children with impaired growth and shorter stature, a common effect of their disease, had worse overall quality of life and poorer physical functioning, an indicator of the importance of early treatment.

Treatments for Children's Kidney Disease

"Timely and individually tailored treatment, be it with nutrition, salt supplements or growth hormones, if needed, can make a big difference. We cannot overemphasize the importance of early intervention in children with early stages of chronic kidney disease," says senior investigator Susan Furth, M.D. Ph.D., a pediatric nephrologist at Hopkins Children's.

The research is part of an ongoing 57-center study funded by the National Institutes of Health to study chronic kidney disease in children.

Reduce Heart Disease, Stroke and Heart Attacks

Scientists writing in The New England Journal of Medicine conclude that lowering the amount of salt people eat by even a small amount could reduce cases of heart disease, stroke and heart attacks as much as reductions in smoking, obesity and cholesterol levels.

If Americans consumed half a teaspoon less salt per day, there would be between 54,000 - 99,000 fewer heart attacks each year and between 44,000 - 92,000 fewer deaths, according to the study, which was conducted by scientists at University of California San Francisco, Stanford University Medical Center and Columbia University Medical Center.

Processed Foods are the Key Source of Salt

Health authorities at federal, state and municipal levels are considering policies to mandate that food companies reduce salt in processed foods, which are considered to be the source of much of the salt Americans eat.

For 40 years in this country we've been trying to get individuals to reduce the amount of sodium we consume and it hasn't worked.

New York City announced an initiative to urge food manufacturers and restaurant chains to reduce salt in their products nationwide by 25 percent over the next five years.

California, according to an author of the study, Kirsten Bibbins-Domingo, an associate professor of medicine and epidemiology at University of California, San Francisco, is considering setting salt limits on food the state purchase for schools, prisons and other public institutions.

The Institute of Medicine, the independent research arm of the National Academies of Science, will be issuing a report soon that will make recommendations about reducing salt intake, including actions government and manufacturers can take.

The Food and Drug Administration was considering whether to change the designation of salt from a food additive that is generally considered safe to a category that would require companies to give consumers more information alerting them to high levels of salt in food.

Greatest Benefit:  Blacks, Hypertension and Seniors

The researchers found that everyone would benefit from less salt, but people at higher risk for heart problems -- blacks, people with hypertension and people over 65 -- would benefit most.

While research isn't showing that individuals will be greatly affected by small changes in salt intake, "Small incremental changes in salt, such as lowering salt in tomato sauce or breads and cereals by a small amount, would achieve small changes in blood pressure that would have a measurable effect across the whole population," researchers said.

Huh?  Does YOUR salt intake affect MY health?   I understand public health concepts, but this seems a bit strained.  However, if what they mean is that people who eat way too much salt will take action and reduce their personal health... I can see that rationale. 

In the meantime, ask your medical adviser if you are overdoing the salt for your own good health!

Read More at NY Times