Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea; Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
Mayo Clin Proc. 2022 Dec;97(12):2259-2270. doi: 10.1016/j.mayocp.2022.04.017. Epub 2022 Nov 3.
To evaluate the association of sodium-potassium intake balance on kidney function.
Data from the Korean Genome and Epidemiology Study were used. The participants were enrolled between June 1, 2001, and January 31, 2003, and were followed-up until December 31, 2016. The 24-hour excretion levels of sodium and potassium were calculated using the Kawasaki formula with spot urinary potassium and sodium measurements. Participants were categorized into tertiles according to the estimated 24-hour urinary sodium-to-potassium (Na/K) ratio. The primary outcome was incident chronic kidney disease (CKD), defined as an estimated glomerular filtration rate of <60 mL/min per 1.73 m in two or more consecutive measurements during the follow-up period.
This study included 4088 participants with normal kidney function. The mean age was 52.4±8.9 years, and 1747 (42.7%) were men. The median estimated 24-hour urinary sodium excretion level, potassium excretion level, and Na/K ratio (inter quartile range) were 4.9 (4.1-5.8) g/d, 2.1 (1.8-2.5) g/d, and 2.3 (1.9-2.7) g/d, respectively. During 37,950 person-years of follow-up (median, 11.5 years), 532 participants developed CKD, and the corresponding incidence rate was 14.0 (95% CI, 12.9-15.3) per 1000 person-years. Multivariable Cox hazard analysis revealed that the risk of incident CKD was significantly lower in the lowest tertile than in the highest tertile (HR, 0.78; 95% CI, 0.63-0.97). However, no significant association was found with incident CKD risk when urinary excretion levels of sodium or potassium were evaluated individually.
A low urinary Na/K ratio may relate with lower CKD development risk in adults with preserved kidney function.
评估钠钾摄入量平衡与肾功能的关系。
本研究使用了韩国基因组和流行病学研究的数据。参与者于 2001 年 6 月 1 日至 2003 年 1 月 31 日入选，并随访至 2016 年 12 月 31 日。使用考克斯公式和即时尿钾、钠测量值计算 24 小时尿钠和钾的排泄水平。根据估计的 24 小时尿钠钾（Na/K）比值，将参与者分为三分位。主要结局为新发慢性肾脏病（CKD），定义为在随访期间两次或两次以上连续测量时估计肾小球滤过率<60 mL/min/1.73 m2。
本研究纳入了 4088 名肾功能正常的参与者。平均年龄为 52.4±8.9 岁，其中 1747 人（42.7%）为男性。中位估计 24 小时尿钠排泄水平、钾排泄水平和 Na/K 比值（四分位距）分别为 4.9（4.1-5.8）g/d、2.1（1.8-2.5）g/d 和 2.3（1.9-2.7）g/d。在 37950 人年的随访期间（中位数 11.5 年），532 名参与者发生 CKD，相应的发病率为 14.0（95%可信区间，12.9-15.3）/1000 人年。多变量 Cox 风险分析显示，与最高三分位相比，最低三分位发生 CKD 的风险显著降低（HR，0.78；95%可信区间，0.63-0.97）。然而，当单独评估尿钠或钾的排泄水平时，与 CKD 发病风险无显著相关性。
在肾功能正常的成年人中，低尿 Na/K 比值可能与较低的 CKD 发展风险相关。
