The importance of salt restriction in the treatment of patients with renal disease has remained highly controversial. In the following we marshal the current evidence that salt plays a definite role in the genesis of hypertension and target organ damage, point to practical problems of salt restriction, and report on novel pathomechanisms of how salt affects blood pressure and causes target organ damage.

Salt restriction may play a crucial role in managing hypertension and preventing organ damage in kidney disease patients, despite practical challenges.

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Salt restriction in kidney disease—a missed therapeutic opportunity?

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