Abstract P294: Urinary Sodium and Potassium Excretion and Progression of Chronic Kidney Disease
Introduction: Chronic kidney disease is a major risk factor for end-stage renal disease, cardiovascular disease, and premature death. There are scarce data on the effects of dietary sodium and potassium intake on the development and progression of chronic kidney disease.
Hypothesis: We investigated the prospective association of urinary sodium and potassium excretion with the risk of chronic kidney disease progression and all-cause mortality among patients with chronic kidney disease.
Methods: The Chronic Renal Insufficiency Cohort study is a prospective, longitudinal cohort study among 3,939 patients with chronic kidney disease from 7 clinical centers in the US. Dietary sodium and potassium intake are accessed by averaging three 24-hour urinary measures and calibrating to sex-specific mean 24-hour urinary creatinine excretion. Estimated-glomerular filtration rate was obtained annually. Chronic kidney disease progression was defined as a composite end point of incident end-stage renal disease or halving of estimated-glomerular filtration rate from baseline.
Results: A total of 905 events of chronic kidney disease progression and 540 deaths from all-causes were identified during follow-up. Overall, a 100-mmol/24 hours higher adjusted sodium excretion was associated with an increased hazard ratio of 1.28 (95% confidence interval 1.17, 1.41; p<0.0001) for chronic kidney disease progression, 1.35 (1.21, 1.50; p<0.0001) for all-cause mortality, and 1.30 (1.21, 1.41; p<0.0001) for the composite outcome. Similar, a 50-mmol/24 hours higher adjusted potassium excretion was associated with increased hazard ratio of 1.56 (1.36, 1.78; p<0.0001) for chronic kidney disease progression, 1.36 (1.15, 1.62; p=0.0004) for all-cause mortality, and 1.51 (1.35, 1.69; p<0.0001) for the composite outcome after adjustment for important covariables, including baseline kidney function, diuretics, and other antihypertensive medication use.
Conclusions: High dietary sodium and potassium intake are associated with increased risk of chronic kidney disease progression and all-cause mortality in patients with chronic kidney disease. These results suggest that a moderate reduction in dietary sodium and potassium intake might slow the progression of chronic kidney disease and reduce all-cause mortality in patients with chronic kidney disease.
Author Disclosures: J. He: None. K.T. Mills: None. L.J. Appel: None. W. Yang: None. J. Chen: None. S.E. Rosas: None. A. Porter: None. G. Makos: None. M.R. Weir: None. L.L. Hamm: None. J. Kusek: None.
- © 2014 by American Heart Association, Inc.