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Urinary Sodium and Potassium Excretion and CKD Progression
Jiang He1, Katherine T Mills2, Lawrence J Appel3
1Departments of Epidemiology and Medicine, Tulane University, New Orleans, Louisiana; jhe@tulane.edu.
Journal of the American Society of Nephrology : JASN
|September 19, 2015
Summary
High urinary sodium and potassium excretion are linked to worse outcomes in chronic kidney disease (CKD). Reducing intake may slow CKD progression and improve survival.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Nutritional Science
Background:
- Chronic kidney disease (CKD) significantly increases risks for end-stage renal disease (ESRD), cardiovascular disease, and mortality.
- The impact of dietary sodium and potassium on CKD progression is not fully understood.
Purpose of the Study:
- To investigate the association between urinary sodium and potassium excretion and the progression of CKD.
- To examine the relationship between these electrolytes and all-cause mortality in CKD patients.
Main Methods:
- Prospective study of 3939 CKD patients from the Chronic Renal Insufficiency Cohort Study.
- Measurement of urinary sodium and potassium via three 24-hour urine collections.
- CKD progression defined as incident ESRD or a 50% decline in estimated glomerular filtration rate (eGFR).
Main Results:
- Higher urinary sodium excretion correlated with increased risk of CKD progression (HR 1.54) and all-cause mortality (HR 1.45).
- Elevated urinary potassium excretion was associated with a higher risk of CKD progression (HR 1.59) and a composite outcome of CKD progression/mortality (HR 1.42).
- These associations remained significant after adjusting for multiple covariates, including baseline eGFR.
Conclusions:
- High urinary sodium and potassium excretion are independently associated with an elevated risk of CKD progression.
- Findings suggest that managing sodium and potassium intake could be crucial for slowing CKD progression.
- Further clinical trials are recommended to confirm the benefits of sodium and potassium reduction in CKD management.
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