Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet
Background : Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2018-12-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.23876/j.krcp.17.0053 |
| _version_ | 1811289459648364544 |
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| author | Se-Yun Kim Yu Ho Lee Yang-Gyun Kim Ju-Young Moon Ho Jun Chin Sejoong Kim Dong Ki Kim Suhnggwon Kim Jung Hwan Park Sung Joon Shin Bum Soon Choi Chun Soo Lim Minjung Lee Sang-ho Lee |
| author_facet | Se-Yun Kim Yu Ho Lee Yang-Gyun Kim Ju-Young Moon Ho Jun Chin Sejoong Kim Dong Ki Kim Suhnggwon Kim Jung Hwan Park Sung Joon Shin Bum Soon Choi Chun Soo Lim Minjung Lee Sang-ho Lee |
| author_sort | Se-Yun Kim |
| collection | DOAJ |
| description | Background :
Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL).
Methods :
A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education.
Results :
Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (−0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (−1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment.
Conclusion :
We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study. |
| first_indexed | 2024-04-13T03:55:16Z |
| format | Article |
| id | doaj.art-2ac66dde7e214b519e2c90c6f051a548 |
| institution | Directory Open Access Journal |
| issn | 2211-9140 |
| language | English |
| last_indexed | 2024-04-13T03:55:16Z |
| publishDate | 2018-12-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-2ac66dde7e214b519e2c90c6f051a5482022-12-22T03:03:39ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91402018-12-0137437338310.23876/j.krcp.17.0053j.krcp.17.0053Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt dietSe-Yun Kim0Yu Ho Lee1Yang-Gyun Kim2Ju-Young Moon3Ho Jun Chin4Sejoong Kim5Dong Ki Kim6Suhnggwon Kim7Jung Hwan Park8Sung Joon Shin9Bum Soon Choi10Chun Soo Lim11Minjung Lee12Sang-ho Lee13Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, KoreaDepartment of Internal Medicine, Kyung Hee University Medical Center, Seoul, KoreaDepartment of Internal Medicine, Kyung Hee University Medical Center, Seoul, KoreaDepartment of Internal Medicine, Kyung Hee University Medical Center, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul, KoreaDepartment of Internal Medicine, Konkuk University School of Medicine, Seoul, KoreaDepartment of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDepartment of Internal Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, KoreaDepartment of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, KoreaDepartment of Clinical Pharmacology, School of Medicine, Kyung Hee University, Seoul, KoreaDepartment of Internal Medicine, Kyung Hee University Medical Center, Seoul, KoreaBackground : Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL). Methods : A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education. Results : Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (−0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (−1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment. Conclusion : We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study.https://doi.org/10.23876/j.krcp.17.0053Chronic kidney diseaseLow-salt dietSodium excretion |
| spellingShingle | Se-Yun Kim Yu Ho Lee Yang-Gyun Kim Ju-Young Moon Ho Jun Chin Sejoong Kim Dong Ki Kim Suhnggwon Kim Jung Hwan Park Sung Joon Shin Bum Soon Choi Chun Soo Lim Minjung Lee Sang-ho Lee Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet Kidney Research and Clinical Practice Chronic kidney disease Low-salt diet Sodium excretion |
| title | Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet |
| title_full | Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet |
| title_fullStr | Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet |
| title_full_unstemmed | Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet |
| title_short | Estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low-salt diet |
| title_sort | estimating the urinary sodium excretion in patients with chronic kidney disease is not useful in monitoring the effects of a low salt diet |
| topic | Chronic kidney disease Low-salt diet Sodium excretion |
| url | https://doi.org/10.23876/j.krcp.17.0053 |
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