Sodium Homeostasis in Chronic Kidney Disease

Adv Chronic Kidney Dis. 2017 Sep;24(5):325-331. doi: 10.1053/j.ackd.2017.08.001.


The pathologic consequences of sodium retention in the CKD population can lead to hypertension, edema, and progressive disease. Sodium excess is responsible for increases in oxidative stress, which alters kidney vasculature. As progression of CKD occurs, hyperfiltration by remaining nephrons compensates for an overall decrease in the filtered load of sodium. In the later stages of CKD, compensatory mechanisms are overcome and volume overload ensues. Nephrotic syndrome as it relates to sodium handling involves a different pathophysiology despite a common phenotype. Extrarenal sodium buffering is also examined as it has significant implications in the setting of advanced CKD.

Keywords: Reabsorption; Regulation; Sodium.

Publication types

  • Review

MeSH terms

  • Animals
  • Atrial Natriuretic Factor / metabolism
  • Diet, Sodium-Restricted
  • Homeostasis
  • Humans
  • Hypertension / metabolism
  • Nephrotic Syndrome / metabolism
  • Oxidative Stress
  • Renal Insufficiency, Chronic / metabolism*
  • Renal Insufficiency, Chronic / physiopathology
  • Renin-Angiotensin System*
  • Skin / metabolism
  • Sodium / metabolism*
  • Sympathetic Nervous System / physiopathology
  • Vasopressins / metabolism


  • Vasopressins
  • Atrial Natriuretic Factor
  • Sodium