The association of parents’ behaviors related to salt with 24 h urinary sodium excretion of their children: A Spanish cross-sectional study

BackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe performed a cross-sectional study of 1545 patients with T2DM over aged 20 years old from January 2018 to December 2020. Urinary sodium excretion was measured by 24-hour urine samples in inpatients and morning fasting urine samples in outpatients. The associations between urinary sodium excretion and the risks of DKD were examined using stepwise regression analysis, logistic regression analysis and multivariable-adjusted restricted cubic splines (RCS).ResultsRegression analysis showed that urinary sodium was independently associated with urinary albumin to creatinine ratio (UACR) level (P = 0.006) and the risks of DKD (P = 0.042). In multivariable-adjusted RCS analysis, urinary sodium excretion was significantly associated with UACR in all patients (P = 0.008), and exhibited a J-shaped relationship. Logistic regression analysis showed that increased urinary sodium excretion was significantly associated with increased risks of DKD [OR (95% CI); 1.56 (1.07-2.27); P = 0.020]. However, the relationships between urinary sodium excretion and the risks of DKD and albuminuria showed no significance, after further adjustment for HOMA-IR and ba-PWV (brachial-ankle pulse wave velocity) (Both P > 0.05).ConclusionsHigher urinary sodium excretion level was associated with increased risks of DKD among patients with T2DM, dependent of vascular sclerosis and insulin resistance.

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Estimation of salt intake by 24-hour urinary sodium excretion: a cross-sectional study in Yantai, China

BMC Public Health ◽

10.1186/1471-2458-14-136 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 29

Author(s):

Jianwei Xu ◽

Maobo Wang ◽

Yuanyin Chen ◽

Baojie Zhen ◽

Junrong Li ◽

...

Keyword(s):

Sodium Excretion ◽

Salt Intake ◽

Urinary Sodium Excretion ◽

Cross Sectional Study ◽

Urinary Sodium ◽

Sectional Study ◽

Cross Sectional

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Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children

Journal of Nutrition ◽

10.1093/jn/nxy211 ◽

2018 ◽

Vol 148 (12) ◽

pp. 1946-1953 ◽

Cited By ~ 6

Author(s):

Magali Rios-Leyvraz ◽

Pascal Bovet ◽

René Tabin ◽

Bernard Genin ◽

Michel Russo ◽

...

Keyword(s):

Sodium Excretion ◽

Salt Intake ◽

Sodium Intake ◽

Population Level ◽

Urinary Sodium Excretion ◽

Cross Sectional Study ◽

Urinary Sodium ◽

Cross Sectional ◽

High Sodium ◽

Individual Level

ABSTRACT Background The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children. Objective The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children. Methods A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics. Results Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8–6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: −0.20 to −0.12 g; correlation: 0.48–0.53; precision: 69.7–76.5%; sensitivity: 76.9–81.6%; specificity: 66.7%; and misclassification: 23.0–27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates. Conclusions Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

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Sex and Body Mass Index Modify the Association Between Leptin and Sodium Excretion: A Cross-sectional Study in an African Population

American Journal of Hypertension ◽

10.1093/ajh/hpz106 ◽

2019 ◽

Vol 32 (11) ◽

pp. 1101-1108

Author(s):

Nora Schwotzer ◽

Michel Burnier ◽

Marc Maillard ◽

Pascal Bovet ◽

Fred Paccaud ◽

...

Keyword(s):

Body Mass Index ◽

Sodium Excretion ◽

Urinary Sodium Excretion ◽

Cross Sectional Study ◽

Sodium Reabsorption ◽

Lithium Clearance ◽

Sectional Study ◽

Cross Sectional ◽

Renal Sodium Handling ◽

Sodium Handling

Abstract BACKGROUND Renal sodium handling could be a potential mediator linking adipokines to hypertension. The aim of the study was to assess the relationship of leptin with urinary sodium excretion and proximal sodium reabsorption in humans. METHODS This cross-sectional study was conducted on participants of hypertensive families from the Seychelles Island. A split urine (daytime and nighttime) collection and plasma leptin were measured. Endogenous lithium clearance was used to assess proximal sodium reabsorption. Mixed multiple linear regression tests adjusted for confounding factors were used. RESULTS Three hundred and sixty-five participants (57% women) were included in this analysis. Leptin and adiponectin were higher in women (P < 0.001). Leptin was associated positively with daytime (coefficient [c]: 0.16, standard deviation (SD): 0.03, P < 0.001), nighttime urinary sodium excretion (c: 0.17, SD: 0.04), P < 0.01), daytime lithium clearance (c: 0.40, SD: 0.08, P < 0.001), and nighttime lithium clearance (c: 0.39, SD: 0.10, P < 0.001) after adjusting for sex. The association was lost or mitigated only when BMI was introduced in the model. When BMI was categorized in normal vs. overweight participant, leptin was associated with daytime and nighttime sodium excretion rates (c: 0.14, SD: 0.05, P = 0.011 and c: 0.22, SD: 0.07, P = 0.002, respectively) only in overweight participants. CONCLUSION Leptin is associated positively with daytime and nighttime sodium excretion and lithium clearance suggesting a natriuretic rather than a sodium retaining effect of leptin. Sex and body mass index (BMI) are major confounders in this association. These results highlight the importance of sex and obesity in our understanding of the relationships between leptin, blood pressure, and renal sodium handling.

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Comment on “Urinary sodium-to-potassium ratio associates with hypertension and current disease activity in patients with rheumatoid arthritis: a cross-sectional study”: authors’ reply

Arthritis Research & Therapy ◽

10.1186/s13075-021-02577-w ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Hiroto Minamino ◽

Masao Katsushima ◽

Yoshihito Fujita ◽

Motomu Hashimoto

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Cross Sectional Study ◽

Urinary Sodium ◽

Sectional Study ◽

Cross Sectional

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Impaired Daytime Urinary Sodium Excretion Impacts Nighttime Blood Pressure and Nocturnal Dipping at Older Ages in the General Population

Nutrients ◽

10.3390/nu12072013 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2013

Author(s):

Rosaria Del Giorno ◽

Chiara Troiani ◽

Sofia Gabutti ◽

Kevyn Stefanelli ◽

Sandro Puggelli ◽

...

Keyword(s):

Blood Pressure ◽

Sodium Excretion ◽

Urinary Sodium Excretion ◽

Urinary Sodium ◽

P Value ◽

Excretion Ratio ◽

Cross Sectional ◽

Nocturnal Dipping ◽

Nighttime Blood Pressure ◽

The Impact

The circadian rhythm of urinary sodium excretion is related to the diurnal blood pressure regulation (BP) and the nocturnal dipping pattern. The renal sodium excretion expressed as daytime/nighttime ratio impacts BP, but a limited number of studies have investigated this topic to date. In this cross-sectional study, we aimed to investigate the impact of different daily patterns of sodium excretion (comparing low with high ratios) on BP and nocturnal dipping and to explore the relationship with age. Twenty-four-hour ambulatory BP monitoring and daytime and nighttime urinary sodium collections were used to assess 1062 subjects in Switzerland. Analyses were performed according to the day/night urinary sodium excretion ratio quartiles (Q1–Q4) and by age group (≤50 and ≥50 years). Subjects in Q1 can be considered low excretors of sodium during the daytime since the rate of sodium excretion during the daytime was 40% lower than that of subjects in Q4. Quartiles of the day/night urinary sodium excretion ratio showed that subjects in Q1 were 7 years older and had respectively 6 and 5 mmHg higher nighttime systolic and diastolic BP and a higher nocturnal dipping compared with subjects in Q4 (p-value ≤0.001). Associations found were significant only for subjects older than 50 years (all p < 0.05). The present results suggest that a decreased capacity to excrete sodium during daytime is more prevalent as age increases and that it impacts nighttime blood pressure and nocturnal dipping in older subjects.

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