ABSTRACT
In 1904, Leo Ambard, who was credited with the first documentation of a correlation
between blood pressure (BP) and salt intake, was in fact searching for the potential
antihypertensive effect of protein restriction in patients with presumably “renal” hyper-
tension (1). Forty years later, Walter Kempner, who demonstrated that progressive renal
function deterioration may be arrested in patients with malignant hypertension kept on a
diet extremely poor in sodium, was convinced that the main characteristic of his rice diet
was its low protein content (2). Although it is possible that changes in protein as well as
caloric intake are confounding factors in the assessment of the dietary approach of kidney
disease, it is difficult to understand why nephrologists have paid so little attention to
long-term changes in sodium intake as a factor susceptible to modify the progression of
renal damage.