Multimodal Receptor Architecture for Dietary Sodium Reduction Without Potassium Chloride: Crystal Hydrodynamics, Proton-Heat Cross-Modality, Kokumi CaSR Allostery, and Retronasal Aroma Compensation

Structured Abstract

Patients with advanced chronic kidney disease (CKD Stages 3-5 and maintenance dialysis) are advised to restrict dietary sodium (<2.0 g/day per KDIGO 2024), yet commercial potassium chloride (KCl) salt substitutes pose severe hyperkalemia risks (Greer et al., Hypertension, 2020) and activate bitter receptors TAS2R (Sinopoli & Lawless, 2012). This paper synthesizes primary sensory and physiological literature across four non-KCl sodium-reduction mechanisms: (1) salt crystal morphology and spatial contrast, distinguishing volumetric spoon-density differences (47%-53% lower Na mass per tablespoon for hollow flake/hopper pyramids vs. cubic table salt; USDA FDC 173468) from gram-for-gram human sensory reductions (20%-25% via dissolution kinetics, Rama et al., 2013; 28% via surface spatial distribution, Noort et al., 2010); (2) organic acid proton (OTOP1; Tu et al., 2018) and trigeminal capsaicin/piperine (TRPV1; Tominaga et al., 1998) cross-modal central salt enhancement (~2.5 g/day salt reduction in human trials; Li et al., Hypertension, 2017); (3) allosteric activation of the calcium-sensing receptor (CaSR) by gamma-glutamyl peptides in slow-roasted alliums (Ohsu et al., JBC, 2010); and (4) retronasal odor-induced saltiness enhancement (OISE, compensating 20%-30% NaCl reduction; Lawrence et al., 2009).

Keywords: sodium reduction, neurogastronomy, ENaC, OTOP1, TRPV1, calcium-sensing receptor, kokumi, chronic kidney disease, hyperkalemia

Target Open-Science Venues & Open Referee Questions

1. Confirm that volumetric spoon density (47%-53%) and gram-for-gram sensory savings (20%-28%) are clearly distinguished throughout.
2. Verify Registered Dietitian clinical sign-off on patient-facing summary points (starfruit caramboxin contraindication, 'phos' label check, dried mushroom potassium caution, and measured table-salting rule).

BibTeX Citation Record

@article{kdigo2024ckd,
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  number  = {4S},
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  year    = {2024},
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}
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}
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