Decompensated Cirrhosis with Ascites: Low Sodium/Salt diets: What is a typical maximum daily limit on amount injested

In many past postings the subscriber has mentioned he or she is on a low salt diet and or is adhering strictly to one but few if any actually indicate what maximum level of salt intake their diet involves.

If I have correctly understood what I have read on the subject, including the British Liver Trust publication ‘Diet and Liver Disease’ ( see in particular page 24 which is under the heading decompensated cirrhosis’) an American publication ‘General Recommendations for Patients with Advanced Cirrhosis’ , a bmjjournals publication ‘Guidelines on management of ascites in cirrhosis’ by Professor K Moore and GP Aithal of UCL Institute of Hepatology Royal Free and University College Medical School, London and Queens College Medical Centre University Hospital, Nottingham, respectively, the Patient UK article for healthcare professionals ‘Ascites’ as well as others; they all appear to advocate that the treatment of ascites requires that the salt intake should be kept to under 5.2 gm daily alongside a prescribed diuretics regime.

In some other articles I have read,different maximum levels ranging from 1gm to 3 gm are quoted.

Regarding the quoted lower maximum levels it appears that unless there are exceptional circumstances such as when there are very large ascites that require very frequent drainage and do not respond to diuretics or when they can not be used then very low maximum levels are no longer recommended because of possible protein malnutrition and other complications that can occur.

I have decompensated cirrhosis with mild / moderate ascites and my own consultant has recommended that I should keep a watch on my daily salt intake but did not make any recommendation about the maximum level but did advise me that I must not to add salt at the table and avoid eating processed and tinned foods pies and sauces etc. Further to be cautious about buying bottled water which apparently often has a high sodium/salt content and to also try and follow the traffic light on food labelling system by eating mainly those foods denoted by green and with only occasional and selective visits into the amber. When I fairly recently saw a registered dietician she said I should aim to keep the salt level under 1 gm daily but personally I find that virtually impossible to achieve. Nevertheless I have kept that target in mind during my subsequent and current dieting but have usually only managed to keep the maximum levels to circa 2 -3 gm daily. If I used what seems to be the higher maximum level of 5.2 gm advocated in the British Liver Trust and the other publications referred to above as a ceiling then for me that would be a doddle.

It would be interesting to hear from others that follow low sodium / salt diets what daily maxims they use and or it has been recommended they endeavour to adhere to. This may reveal whether there is indeed a typical recommended ceiling or is something that is very ad hoc.

Finally I just wish there were places here in the UK that sell very low / nil salt bread and or the original no salt tuscan bread and despite searching I have not yet found one. I have tried baking my own but not successfully at least in so far as it being edible is concerned.

I hope this will generate some responses from those that follow low sodium/salt diets because personally I find this another aspect of treating liver disease that is very confusing.

Regards to all

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4 Replies

  • I recently found this publication which is provided to liver cirrhosis patients in Michigan, USA. It is quite simply written for patients and includes a big section on low salt diet, management of ascites etc. It seems quite good. Hope it helps some folks.


  • Hello Katie,

    Thank you for forwarding that link and I agree that it is a nice nice easy to read and simple to understand publication. I have printed off a copy for future reference. Interesting to see that it too recommends a ceiling of circa 5gm daily of salt (5000 mg of sodium) assuming my maths is correct.


  • Hi

    I had large ascites earlier this year. Since then I have followed the dieticians advice of no more than 5.2gm of salt per day and no more than 1.25g of salt in any one sitting.

    As you say, aiming for 1gm of salt per day is nigh on impossible.

    I have had to change my diet considerably but it is second nature now and I typically eat around 2-4gm of salt per day. Some of the salt content in processed food is shocking to me now...over 3g in some sandwiches and pizzas, curries, etc. Wow! I had a bad diet when I did eat (kinda gave up on food when my alcoholism reached its peak) but I would guess on a typical day I was ingesting approx 10-12gm of salt.

    The bread aspect is very annoying.

    A recent scan showed my ascites is gone and I am off diuretics for the first time in 6 months. Time will tell if the ascites returns but I intend to stick to my usual low salt levels (and cling to my sobriety of course).

  • I agree the low salt diet is miserable and when that is also combined with low potassium (needed when on diuretics like spionolactone) it's a nightmare. My Consultant told me no more than 1g salt per day. I find that the things I miss the most are cheese, bread and tomatoes (high potassium). Someone made some no salt bread for me but it tasted horrible (Paul Hollywood Great British Bake Off take note!). I was suprised to find salt in virtually everything... even things like yoghurt, ice cream etc. So far the only no salt cereal I have found is Shredded Wheat Bite size Plain. Dieticians at hospital (which has a liver transplant unit) surprisingly not able to give detailed useful advice.

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