The salt paradox and its possible implications in managing hypertensive diabetic patients

Diabetes mellitus is one of the leading causes of end-stage renal disease. The pathogenesis of diabetic nephropathy is still poorly understood, but glomerular injury has been ascribed, at least in part, to glomerular hyperfiltration, which occurs early in the course of diabetes mellitus. Therefore, a better understanding of the early dysfunctions observed in the diabetic kidney may permit the development of new strategies to prevent diabetic nephropathy. In this review, we discuss the pathophysiology for the paradoxical relationship between dietary salt and glomerular filtration rate observed in early diabetes mellitus and possible implications in managing diabetic patients.