Dietary Sodium Intake and Blood Pressure in Living Kidney Donors

Open to people ages 18 years and up

• Living kidney donors who underwent a living kidney donation at least 5 months ago but not more than 12 months
• Age ≥18 years old
• Agree to perform the procedure as per study protocol (Table 1)
• Living kidney donors with an average sitting SBP <160 mmHg at 5-month post-donation measured by automatic office blood pressure (AOBP)
• Able to sign informed consent
• Able to attend all research visits
• Woman using birth control methods other than hormonal contraception

• History of previous cardiovascular (CV) events including acute MI, HF, and stroke
• Symptomatic heart failure within 5 months after living kidney donation or left ventricular ejection fraction (by any method) <35%
• CV event or procedure or hospitalization for hypertensive-related disorders within 5 months after living kidney donation
• Diagnosed with HTN or on antihypertensive medication(s) before living kidney donation
• Patients who are supposed to take BP lowering medications for reasons other than BP control but do not take those medications or take them with in appropriate doses
• Arm circumference is too small or large to allow accurate BP measurement with available 24-h ABPM machines.
• An average standing SBP ≥160 mmHg at 5-month post-donation measured by automatic office blood pressure (AOBP)
• Albuminuria that equals or is equivalent to 1 g per day by using spot urinary albumin per urine creatinine ratio (UACR) or 24-hour urinary albumin excretion rate by a 24-hour urine collection within 5 months post-donation
• Advanced kidney function defined by estimated glomerular filtration rate (eGFR) by using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation22 of <20 ml/min/1.73m2 or requiring dialysis after living kidney donation
• Drink coffee > two 8-ounce (237 mL) cup a day or equivalence
• Drinks alcohol >3 drinks/day or >30 ml/day
• Smoking cigarette ≥10 cigarettes/day
• Take Nonsteroidal anti-inflammatory drugs (NSAIDS)
• Use hormone replacement therapy or oral contraceptives
• Pregnancy, currently trying to become pregnant
• Using birth control pills
• A medical condition likely to limit survival to less than 2 years
• Any factors that are likely to limit adherence to interventions. For example,
  • Living kidney donors who cannot come to follow up regularly per study protocol to logistically collect data from enrolled participants.
  • Active alcohol or substance abuse within the last 5 months of living kidney donation
  • Plans to move outside the clinic catchment area in the next 4 months without the ability to transfer to come to follow up at SPLID study site.
  • Significant history of poor adherences with medications or attendance at clinic visits
  • Significant concerns about participation in the study from spouse, significant other, or family members
  • Lack of support from primary health care provider
  • Residence too far from the study clinic site such that transportation is a barrier including persons who require transportation assistance provided by the SPLID clinic funds for screening or randomization visits
  • Residence in a nursing home or an assisted living
  • Clinical dementia with or without treatment with medications and cognitively unable to follow the protocol
  • Other medical, psychiatric, or behavioral factors that may interfere with study participation or the ability to follow the intervention protocol
  • Inability to obtain informed consent from participant
  • Living in the same household as an already randomized SPLID participant