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Cardiovascular, Endocrine and Renal Responses to Dietary Sodium Restriction in Persons with Paraplegia and Tetraplegia

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The kidneys are richly innervated by the sympathetic nervous system (Sutters 1992). The role of the sympathetic renal nerves in the adaptation to changes in dietary sodium intake in persons with spinal cord injury and impaired sympathetic nervous systems warrant study.

Table 12: Responses to Dietary Sodium Restriction in Persons Post SCI

Discussion

In a study by Sutters et al. (1992) the effects of change from a high to low sodium diet on renal sodium and water excretion and hormonal responses were studied in nine individuals with tetraplegia (dissociated sympathetic control) and in six individuals with paraplegia (intact sympathetic systems). Given the results, the authors suggested that direct sympathetic control of the kidney is not required for renal sodium conservation in response to dietary salt restriction; however, is likely involved in the hemodynamic and hormonal responses.

Conclusion

There is level 3 evidence (from one case control study; Sutters et al. 1992) that sympathetic control of the kidney is not required for renal sodium conservation in response to dietary salt restriction. 

  • Impairment of sympathetic control of the kidney secondary to SCI resulting in tetraplegia does not impact renal sodium conservation in response to dietary salt restriction.