In CKD with type 1 diabetes, salt intake was independently associated

with overall mortality and ESRD, and there was a significant increase in mortality in subjects with urinary sodium excretion =/<50 mmol (salt intake =/<3 g/day). Therefore, we do not suggest further reduction of salt intake to <3 g/day due to the possibility of increasing the mortality and accelerating the progression of renal dysfunction (Grade C2). When salt restriction is difficult, we recommend administration of low-dose diuretics. Thiazide or thiazide-like diuretics in the G1, G2 or G3 categories and loop diuretics in the G4 or G5 categories are beneficial for promoting sodium excretion in CKD. Bibliography 1. Sacks FM, et al. N Engl J Med. 2001;344:3–10. (Level 2)   2. Swift PA, et al. Hypertension. 2005;46:308–12. (Level selleck chemical 2)   3. Cianciaruso B, et al. Miner Electrolyte Metab. 1998;24:296–301. (Level 4)   4. HONEST (HOlland NEephrology STudy) Group. BMJ. 2011;343:d4366. (Level 2)   5. Vegter S, et al. J Am Soc Nephrol. 2012;23:165–73. (Level 4)   6. Lambers Heerspink HJ, et al. Kidney Int. 2012;82:330–7.

(Level 4)   7. Stolarz-Skrzypek K, et al. JAMA. 2011;305:1777–85. (Level 4)   8. Thomas MC, et al. PRI-724 supplier Diabetes Care. 2011;34:861–6. (Level 4)   What kind of anti-hypertensive drugs are recommended as the first line medication for the management of hypertension in CKD? (Fig. 1) Fig. 1 Summary of the recommended management of hypertension with CKD 1. First-line anti-hypertensive drugs for diabetic CKD   In diabetic A2 and A3 category CKD, PtdIns(3,4)P2 we recommend RAS inhibitors as first-line anti-hypertensive drugs. The renal and cardiovascular protective effects of RAS inhibition depend on the degree of albuminuria/proteinuria at the baseline. Thus, we strongly recommend

the RAS inhibitors as the first-line anti-hypertensive drugs for diabetic A2 or A3 category CKD. In T2DM (type 2 diabetes mellitus) patients with normo-albuminuria (A1), ACE-I or ARB SRT1720 chemical structure inhibited the development of micro-albuminuria, particularly in the presence of hypertension. However, there have been no large-scale studies investigating the relative renal or cardiovascular protective effects of RAS inhibitors and other classes of anti-hypertensive drugs with a head-to-head comparison in diabetic CKD patients with reduced GFR and normal urinary albumin excretion. Thus, we tentatively suggest the RAS inhibitors as first-line anti-hypertensive drugs for diabetic CKD with normo-albuminuria (A1). To achieve the recommended clinic BP target, combination therapy should be considered.