Achieving Salt Restriction in Chronic Kidney Disease

Table 3

Summary of studies investigating barriers to adhering to a sodium-restricted diet.

Study country	Population	Barriers to sodium-restricted diet
Welch et al. (2006) [20]; USA	229 hemodialysis pts, aged 55 ± 14 years. 58% male, 79% African American	(i) Taste (58%); (ii) Difficulty when eating out (30%); (iii) Cost (23%); (iv) Difficult to understand (21%); (v) Too time-consuming (17%)
De Brito-Ashurst et al. (2011) [72]; UK	20 female CKD pts, 1st generation immigrants from Bangladesh to the UK, aged 60 ± 8 years; unemployed	(i) Lack of family acceptance (50%, 𝑛=10/20); (ii) Fear that friends will gossip/think the family has no money (40%, 8/20); (iii) No perceived benefit (25%, 𝑛=5/20)
Gordon et al. (2009) [77]; USA	82 transplant recipients aged 47 ± 57 years. 57% male, 56% white	(i) Preferences for salty foods and enjoying taste of salt (𝑛=9); (ii) Lack of available low-salt dishes at restaurants (𝑛=10) or low-salt foods in markets (𝑛=3) and when other people cook using salt (𝑛=3); (iii) Lifestyle factors (𝑛=5) for example, having no time to cook
Ireland et al. (2010) [65]; Australia	43 healthy pts from volunteer database. 23% male, aged 55 ± 11 in “tick group” 57 ± 13 y in “FSANZ group”	(i) Limited variety of appropriate foods; (ii) Difficulty eating out; (iii) Increased time for shopping
Chung et al. (2006) [78]; Australia and United States	68 heart failure patients, aged 63 ± 14 years, 60% male, 63% Caucasian	(i) Trouble choosing foods in restaurants (75%); (ii) Favorite foods aren’t low-salt (72%); (iii) Taste (69%); (iv) Favorite restaurants don’t serve low-salt foods (64%); (v) Insufficient will power to change diet (59%); (vi) Peers don’t eat low-salt foods (54%); (vii) Trouble choosing foods at supermarket (52%); (viii) Poor knowledge/understanding (49%); (ix) Cost (47%); (x) Does not cook (40%); (xi) Time to prepare food (38%); (xii) Person who cooks doesn’t prepare low-salt foods (30%)
Bentley et al. (2005) [79]; USA	20 heart failure patients (recruited from 1 clinic) who had received a healthcare provider’s recommendation to follow a low sodium diet, aged 60 ± 11 years 60% male, 80% non-Hispanic White	(i) Lack of knowledge (need for more detailed dietary information, confusion for pts with additional dietary restrictions); (ii) Lack of perceived benefit; (iii) Interference with socialization (family conflict, difficulty eating out); (iv) Limited food choices/lack of palatability

Figures as mean ± standard deviation. Abbreviations: CKD: chronic kidney disease, FSANZ: Food Standards Australia New Zealand, Pts: participants.