Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania.
Nutrients. 2024 Oct 7;16(19):3400. doi: 10.3390/nu16193400.
Albuminuria and albumin excretion rate (AER) are important risk factors for chronic kidney disease (CKD) development. Despite the extensive evidence of the influence of sodium and potassium on cardiovascular health, the existing evidence regarding their impact on albuminuria and kidney disease is limited and inconsistent. Our study aimed to assess the correlation between urinary sodium and potassium excretion, and the sodium-to-potassium ratio (Na/K ratio) with impaired kidney function, particularly the AER and albuminuria. Data were collected from the Lithuanian NATRIJOD study. A total of 826 single 24-h urine samples from individuals aged 18 to 69 were collected and analyzed for their sodium and potassium levels, Na/K ratio, and AER. Albuminuria was defined as an AER exceeding 30 mg/24 h. The participant mean age was 47.2 ± 12.1 years; 48.5% of the participants were male. The prevalence of albuminuria was 3%. Correlation analysis revealed a positive correlation between AER and urinary sodium excretion (r = 0.21; < 0.001) and urinary potassium excretion (r = 0.28; < 0.001). In univariate linear regression analysis, sodium and potassium excretion and the Na/K ratio were significant AER predictors with coefficients of 0.028 (95% CI: 0.015; 0.041; < 0.001), 0.040 (95% CI: 0.003; 0.077; = 0.035), and 1.234 (95% CI: 0.210; 2.259; = 0.018), respectively. In the multivariable model, only urinary sodium excretion remained significant, with a coefficient of 0.028 (95% CI: 0.016; 0.041). Potential albuminuria predictive factors identified via univariate logistic regression included urinary sodium excretion (OR 1.00; 95% CI: 1:00; 1.01) and the Na/K ratio (OR 1.53; 95% CI: 1.11; 2.05). However, these factors became statistically insignificant in the multivariate model. Urinary sodium and potassium excretion and the Na/K ratio are significantly associated with kidney damage, considering the assessed 24-h albumin excretion rate and presence of albuminuria content.
尿白蛋白和白蛋白排泄率（AER）是慢性肾脏病（CKD）发展的重要危险因素。尽管有大量证据表明钠和钾对心血管健康有影响，但关于它们对白蛋白尿和肾脏疾病影响的现有证据是有限的，且不一致。我们的研究旨在评估尿钠和钾排泄以及钠钾比值（Na/K 比值）与肾功能受损的相关性，特别是 AER 和白蛋白尿。数据来自立陶宛的 NATRIJOD 研究。共收集了 826 名年龄在 18 至 69 岁的个体的单次 24 小时尿液样本，并分析了其钠和钾水平、Na/K 比值和 AER。白蛋白尿定义为 AER 超过 30mg/24h。参与者的平均年龄为 47.2±12.1 岁；48.5%的参与者为男性。白蛋白尿的患病率为 3%。相关性分析显示，AER 与尿钠排泄（r=0.21；<0.001）和尿钾排泄（r=0.28；<0.001）呈正相关。在单变量线性回归分析中，钠和钾的排泄以及 Na/K 比值是 AER 的显著预测因子，其系数分别为 0.028（95%置信区间：0.015；0.041；<0.001）、0.040（95%置信区间：0.003；0.077；=0.035）和 1.234（95%置信区间：0.210；2.259；=0.018）。在多变量模型中，只有尿钠排泄仍然具有显著性，系数为 0.028（95%置信区间：0.016；0.041）。通过单变量逻辑回归识别的潜在白蛋白尿预测因子包括尿钠排泄（OR 1.00；95%置信区间：1:00；1.01）和 Na/K 比值（OR 1.53；95%置信区间：1.11；2.05）。然而，这些因素在多变量模型中变得不具有统计学意义。尿钠和钾的排泄以及 Na/K 比值与肾脏损害显著相关，考虑到评估的 24 小时白蛋白排泄率和白蛋白尿含量。
