scholarly journals Urinary Potassium and Kidney Function Decline in the Population—Observational Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2747
Author(s):  
Massimo Cirillo ◽  
Giancarlo Bilancio ◽  
Pierpaolo Cavallo ◽  
Raffaele Palladino ◽  
Enrico Zulli ◽  
...  
Keyword(s):  
Kidney Function ◽  
Population Based ◽  
Dietary Sodium ◽  
Study Cohort ◽  
Creatinine Ratio ◽  
Time Data ◽  
High Potassium ◽  
Cross Sectional ◽  
Potassium Intake ◽  
Urinary Potassium

Background—Some data suggest favorable effects of a high potassium intake on kidney function. The present population-based study investigated cross-sectional and longitudinal relations of urinary potassium with kidney function. Methods—Study cohort included 2027 Gubbio Study examinees (56.9% women) with age ≥ 18 years at exam-1 and with complete data on selected variables at exam-1 (1983–1985), exam-2 (1989–1992), and exam-3 (2001–2007). Urinary potassium as urinary potassium/creatinine ratio was measured in daytime spot samples at exam-1 and in overnight timed collections at exam-2. Estimated glomerular filtration rate (eGFR) was measured at all exams. Covariates in analyses included demographics, anthropometry, blood pressure, drug treatments, diabetes, smoking, alcohol intake, and urinary markers of dietary sodium and protein. Results—In multivariable regression, urinary potassium/creatinine ratio cross-sectionally related to eGFR neither at exam-1 (standardized coefficient and 95%CI = 0.020 and −0.059/0.019) nor at exam-2 (0.024 and −0.013/0.056). Exam-1 urinary potassium/creatinine ratio related to eGFR change from exam-1 to exam-2 (0.051 and 0.018/0.084). Exam-2 urinary potassium/creatinine ratio related to eGFR change from exam-2 to exam-3 (0.048 and 0.005/0.091). Mean of urinary potassium/creatinine ratio at exam-1 and exam-2 related to eGFR change from exam-1 to exam-3 (0.056 and 0.027/0.087) and to incidence of eGFR < 60 mL/min per 1.73 m2 from exam-1 to exam-3 (odds ratio and 95%CI = 0.78 and 0.61/0.98). Conclusion—In the population, urinary potassium did not relate cross-sectionally to eGFR but related to eGFR decline over time. Data support the existence of favorable effects of potassium intake on ageing-associated decline in kidney function.

scholarly journals P0732DOES KIDNEY FUNCTION INFLUENCE PLASMA ADIPONECTIN CONCENTRATION IN ELDERLY CAUCASIANS?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marcin Adamczak ◽  
Sylwia Dudzicz ◽  
Jerzy Chudek ◽  
Jan Zejda ◽  
Tomasz Zdrojewski ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Kidney Function ◽  
Multivariate Regression Analysis ◽  
Population Based ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Study Cohort ◽  
Adiponectin Concentration ◽  
Cross Sectional ◽  
Plasma Adiponectin

Abstract Background and Aims Adiponectin is a hormone produced almost exclusively by the adipose tissue with vaso-protective activity and mostly metabolized in the kidneys. Glomerular filtration rate (GFR) is declining with age in elderly subjects and therefore it is expected to be followed by accumulation of adiponectin in the circulation. The aim of this study was to assess the plasma concentration of adiponectin in relation to GFR in the older population-based on the PolSenior study cohort. Method The PolSenior study was a multicenter cross-sectional study which assessed the health status of older adults in Poland. In 3913 subjects aged 65 years or above (2041 male and 1872 female, BMI 28.1±5.1 kg/m2, mean age 79±9 years) plasma adiponectin concentration (ELISA; B-Bridge International) was measured. GFR was estimated using a short MDRD formula. All results are presented as means with standard deviations. Results In studied subjects eGFR was 76 ml/min/1.73 m2. eGFR below 60 ml/min/1.73 m2 was observed in 842 (22%) subjects. Plasma concentration of adiponectin was 11.9±6.4 µg/ml. In subjects with eGFR &lt; 60 ml/min/1.73 m2 significantly higher plasma adiponectin concentrations were observed compared to subjects with eGFR ≥ 60 ml/min/1.73 m2 (12.5±6.7 vs. 11.8±6.3 respectively, p=0.01). Plasma adiponectin concentration depends strongly on BMI (R= -0.28; p&lt;0.001) and marginally on the kidney function (R=-0.05; p=0.005). Multivariate regression analysis including plasma adiponectin concentration, BMI, eGFR, occurrence of diabetes mellitus and hypertension, showed that BMI and prevalence of diabetes (b=-0.24, p&lt;0.001, b=-0.11, p&lt;0.0001, respectively) but not eGFR explain variability of plasma adiponectin concentration. Conclusion Plasma adiponectin concentration is only slightly affected by kidney function in elderly Caucasians from the PolSenior study.

scholarly journals Sodium intake and kidney function in the general population: an observational, population-based study

2020 ◽  
Author(s):  
Massimo Cirillo ◽  
Giancarlo Bilancio ◽  
Pierpaolo Cavallo ◽  
Raffaele Palladino ◽  
Oscar Terradura-Vagnarelli ◽  
...  
Keyword(s):  
General Population ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Sodium Intake ◽  
Multivariable Analysis ◽  
Population Based ◽  
Study Cohort ◽  
Cross Sectional ◽  
Adult Participants

Abstract Background The relationships of sodium intake to kidney function within the population have been poorly investigated and are the objective of the study. Methods This observational, population-based, cross-sectional and longitudinal study targeted 4595 adult participants of the Gubbio study with complete data at baseline exam. Of these participants, 3016 participated in the 15-year follow-up (mortality-corrected response rate 78.4%). Baseline measures included sodium:creatinine ratio in timed overnight urine collection, used as an index of sodium intake, together with serum creatinine, sex, age and other variables. Follow-up measures included serum creatinine and other variables. Estimated glomerular filtration rate (eGFR, mL/min/1.73 m2) was calculated using serum creatinine, sex and age and was taken as an index of kidney function. Results The study cohort was stratified in sex- and age-controlled quintiles of baseline urine sodium:creatinine ratio. A higher quintile associated with higher baseline eGFR (P &lt; 0.001). In multivariable analysis, the odds ratio (OR) of Stage1 kidney function (eGFR ≥90 mL/min/1.73 m2) was 1.98 times higher in Quintile 5 compared with Quintile 1 [95% confidence interval (CI) 1.50–2.59, P &lt; 0.001]. The time from baseline to follow-up was 14.1 ± 2.5 years. Baseline to follow-up, the eGFR change was more negative along quintiles (P &lt; 0.001). In multivariable analysis, the OR in Quintile 5 compared with Quintile 1 was 2.21 for eGFR decline ≥30% (1.18–4.13, P = 0.001) and 1.38 for worsened stage of kidney function (1.05–1.82, P = 0.006). Findings were consistent within subgroups. Conclusions Within the general population, an index of higher sodium intake associated cross-sectionally with higher kidney function but longitudinally with greater kidney function decline.

scholarly journals Sodium and Potassium Intakes assessed by 24-h Urine among Moroccan University students in Casablanca, Morocco: Cross-Sectional Study

2021 ◽  
Vol 119 ◽  
pp. 04003
Author(s):  
Maria Elarbaoui ◽  
Ali Jafri ◽  
Younes Elkardi ◽  
Houria Makhlouki ◽  
Basma Ellahi ◽  
...  
Keyword(s):  
Salt Intake ◽  
Action Plan ◽  
Cross Sectional Study ◽  
Dietary Sodium ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Potassium Intake ◽  
Urinary Potassium ◽  
Sodium And Potassium

In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Creatinine excretion was used to validate the completeness of the urine collections. The average urinary sodium excretion was 3125.77 ± 121.99 mg/day, 13.5% consumed less than 5g/day, while 69% consumed more than 5 g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1826.1 ± 61.2 mg/day, and more than 98% of the students consumed less than the adequate intake. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt.

scholarly journals Dietary Sodium and Potassium Intake in Hungarian Elderly: Results from the Cross-Sectional Biomarker2019 Survey

2021 ◽  
Vol 18 (16) ◽  
pp. 8806
Author(s):  
Eszter Sarkadi-Nagy ◽  
Andrea Horváth ◽  
Anita Varga ◽  
Leonóra Zámbó ◽  
Andrea Török ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
World Health ◽  
Reliable Estimate ◽  
Cross Sectional ◽  
Potassium Intake ◽  
Urinary Potassium ◽  
The Mean ◽  
Sodium And Potassium

High sodium intake and inadequate potassium intake are associated with high blood pressure. The elderly are more salt sensitive than other age groups, yet a reliable estimate of the dietary sodium and potassium intake of this age group in Hungary is unavailable. The study aimed to estimate the sodium and potassium intakes in the Hungarian elderly from 24 h urine sodium and potassium excretion. In this cross-sectional study, participants were selected from patients of general practitioners practicing in western Hungary. The participants comprised 99 men and 90 women (mean age 67.1 (SD 5.4] years) who participated in the Biomarker2019 survey and returned a complete 24 h urine collection. We assessed dietary sodium and potassium by determining 24 h urinary sodium and potassium excretions and 3-day dietary records. The mean urinary sodium was 188.8 (73.5) mmoL/day, which is equivalent to 11.0 g of salt/day; and the mean urinary potassium was 65.8 (24.3) mmoL/day, which is equivalent to 3.03 g of potassium/day, after adjusting for non-urinary potassium losses. Only 7% of the subjects met the World Health Organization’s recommended target of less than 5 g of salt/day, and 33% consumed at least the recommended potassium amount of 3.5 g/day, based on the estimates from 24 h urine excretion. For most elderly, sodium intake exceeds, and potassium does not reach, dietary recommendations. The results underline the need to intensify salt reduction efforts in Hungary.

scholarly journals Diminished Antiproteinuric Effect Of The Angiotensin Receptor Blocker Losartan During High Potassium Intake In Patients With Ckd

2021 ◽  
Author(s):  
Rosa D Wouda ◽  
Femke Waanders ◽  
Dick de Zeeuw ◽  
Gerjan Navis ◽  
Liffert Vogt ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Angiotensin Receptor Blockers ◽  
Dietary Sodium ◽  
Angiotensin Receptor ◽  
High Potassium ◽  
Potassium Intake ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Urinary Potassium

Abstract Background Angiotensin receptor blockers (ARBs) lower blood pressure (BP) and proteinuria and reduce renal disease progression in many—but not all—patients. Reduction of dietary sodium intake improves these effects of ARBs. Dietary potassium intake affects BP and proteinuria. We set out to address the effect of potassium intake on BP and proteinuria response to losartan in non-diabetic proteinuric chronic kidney disease (CKD) patients. Methods We performed a post-hoc analysis of a placebo-controlled interventional cross-over study in 33 non-diabetic proteinuric patients (baseline mean arterial pressure and proteinuria: 105 mmHg and 3.8 g/d, respectively). Patients were treated for 6 weeks with placebo, losartan, and losartan/hydrochlorothiazide, combined with a habitual (∼200 mmol/d) and low-sodium diet (&lt;100 mmol/d), in randomized order. To analyze the effects of potassium intake, we categorized patients based on median split of 24 h urinary potassium excretion, reflecting potassium intake. Results Mean potassium intake was stable during all 6 treatment periods. Losartan and losartan/hydrochlorothiazide lowered BP and proteinuria in all treatment groups. Patients with high potassium intake showed no difference in the BP effects compared to patients with low potassium intake. The antiproteinuric response to losartan monotherapy and losartan combined with hydrochlorothiazide during the habitual sodium diet was significantly diminished in patients with high potassium intake (20% vs. 41%, p = 0.011 and 48% vs 64%, p = 0.036). These differences in antiproteinuric response abolished when shifting to the low sodium diet. Conclusions In proteinuric CKD patients, the proteinuria, but not BP-lowering response to losartan during a habitual high sodium diet was hampered during high potassium intake. Differences disappeared after sodium status change by low-sodium diet.

scholarly journals Paradata analyses to inform population-based survey capture of pregnancy outcomes: EN-INDEPTH study

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Vladimir Sergeevich Gordeev ◽  
◽  
Joseph Akuze ◽  
Angela Baschieri ◽  
Sanne M. Thysen ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Population Based ◽  
Reproductive Age ◽  
Maternal And Newborn Health ◽  
Time Data ◽  
Additional Time ◽  
Electronic Data ◽  
Cross Sectional ◽  
Improve Measurement ◽  
Population Based Survey

Abstract Background Paradata are (timestamped) records tracking the process of (electronic) data collection. We analysed paradata from a large household survey of questions capturing pregnancy outcomes to assess performance (timing and correction processes). We examined how paradata can be used to inform and improve questionnaire design and survey implementation in nationally representative household surveys, the major source for maternal and newborn health data worldwide. Methods The EN-INDEPTH cross-sectional population-based survey of women of reproductive age in five Health and Demographic Surveillance System sites (in Bangladesh, Guinea-Bissau, Ethiopia, Ghana, and Uganda) randomly compared two modules to capture pregnancy outcomes: full pregnancy history (FPH) and the standard DHS-7 full birth history (FBH+). We used paradata related to answers recorded on tablets using the Survey Solutions platform. We evaluated the difference in paradata entries between the two reproductive modules and assessed which question characteristics (type, nature, structure) affect answer correction rates, using regression analyses. We also proposed and tested a new classification of answer correction types. Results We analysed 3.6 million timestamped entries from 65,768 interviews. 83.7% of all interviews had at least one corrected answer to a question. Of 3.3 million analysed questions, 7.5% had at least one correction. Among corrected questions, the median number of corrections was one, regardless of question characteristics. We classified answer corrections into eight types (no correction, impulsive, flat (simple), zigzag, flat zigzag, missing after correction, missing after flat (zigzag) correction, missing/incomplete). 84.6% of all corrections were judged not to be problematic with a flat (simple) mistake correction. Question characteristics were important predictors of probability to make answer corrections, even after adjusting for respondent’s characteristics and location, with interviewer clustering accounted as a fixed effect. Answer correction patterns and types were similar between FPH and FBH+, as well as the overall response duration. Avoiding corrections has the potential to reduce interview duration and reproductive module completion by 0.4 min. Conclusions The use of questionnaire paradata has the potential to improve measurement and the resultant quality of electronic data. Identifying sections or specific questions with multiple corrections sheds light on typically hidden challenges in the survey’s content, process, and administration, allowing for earlier real-time intervention (e.g.,, questionnaire content revision or additional staff training). Given the size and complexity of paradata, additional time, data management, and programming skills are required to realise its potential.

scholarly journals Reduced Kidney Function and Relative Hypocalciuria—Observational, Cross-Sectional, Population-Based Data

2020 ◽  
Vol 9 (12) ◽  
pp. 4133
Author(s):  
Massimo Cirillo ◽  
Giancarlo Bilancio ◽  
Pierpaolo Cavallo ◽  
Francesco Giordano ◽  
Gennaro Iesce ◽  
...  
Keyword(s):  
Kidney Function ◽  
Population Based ◽  
Calcium Handling ◽  
Urine Calcium ◽  
Cross Sectional ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Calcium Load ◽  
Reduced Kidney Function ◽  
Low Serum

This observational, cross-sectional, epidemiological analysis investigated relationships of kidney function to urine calcium and other variables. The analyses targeted two population-based samples of adults (Gubbio study and Moli-sani study: n = 3508 and 955, respectively). Kidney function was assessed as estimated glomerular filtration rate (eGFR). Calcium/creatinine ratio (Ca/Cr) was used as index of urinary calcium in timed overnight urine under fed condition (Gubbio study), morning urine after overnight fast (Gubbio study), and first-void morning urine (Moli-sani study). Moli-sani study included also data for glomerular filtered calcium load, tubular calcium handling, and serum phosphorus, parathyroid hormone, 1,25-dihydroxyvitamin D, calcium, and 25-hydroxyvitamin D. eGFR positively and independently related to Ca/Cr (p < 0.001). In multivariate analyses, eGFR lower by 10 mL/min × 1.73 m2 related to overnight urine Ca/Cr lower by 14.0 mg/g in men and 17.8 mg/g in women, to morning urine Ca/Cr lower by 9.3 mg/g in men and 11.2 mg/g in women, and to first-void urine Ca/Cr lower by 7.7 mg/g in men and 9.6 mg/g in women (p < 0.001). eGFR independently related to glomerular filtered calcium load (p < 0.001) and did not relate to tubular calcium handling (p ≥ 0.35). In reduced eGFR only (<90 mL/min × 1.73 m2), low urine Ca/Cr independently related to low serum 1,25-dihydroxyvitamin D (p = 0.002) and did not relate to hyperphosphatemia, high serum parathyroid hormone, or hypocalcemia (p ≥ 0.14). Population-based data indicated consistent associations of lower kidney function with lower urine calcium due to reduction in glomerular filtered calcium. In reduced kidney function, relative hypocalciuria associated with higher prevalence of low serum 1,25-dihydroxyvitamin D.

scholarly journals Salt Consumption in Latvian Population: A Pilot Study

Medicina ◽  
2018 ◽  
Vol 54 (1) ◽  
pp. 10
Author(s):  
Ilva Lazda ◽  
Māris Goldmanis ◽  
Inese Siksna
Keyword(s):  
Pilot Study ◽  
Sodium Intake ◽  
Large Population ◽  
Population Based ◽  
Dietary Sodium ◽  
World Health ◽  
Food Diary ◽  
Potassium Intake ◽  
Sodium And Potassium ◽  
Dietary Data

Background and objective: High dietary sodium intake is associated with multiple health risks, and the average sodium intake in Latvia is higher than the World Health Organization has recommended. In Latvia, no study so far has combined self-reported dietary data on sodium and potassium intake with objective measurements in 24-h urine samples. This pilot study aimed to cross-validate both methods and to assess any possible factors interfering with the collection of samples and data in large, population-based future studies of sodium and potassium intake in Latvian adults. Materials and methods: A stratified random sample of healthy Latvian adults aged 19–64 (n = 30) was drawn. Dietary data of sodium and potassium was collected using one 24-h dietary recall and a two-day food diary. Sodium and potassium excretion was measured by one 24-h urinary collection. Results: Median intake of sodium and potassium based on dietary data was 2276.4 mg/day (interquartile range (IQR), 1683.3–3979.4) and 2172.0 mg/day (IQR, 1740.6–3506.5), respectively. Median intake of sodium and potassium based on urinary data was 3500.3 mg/day (IQR, 2191.0–5535.0) and 2965.4 mg/day (IQR, 2530.2–3749.9), respectively. Urinary data showed significantly higher results than dietary records (Wilcoxon signed rank test, p = 0.023). Only 13% of the subjects did not exceed the WHO-recommended limit of 2000 mg of sodium per day, and only 33% consumed at least the recommended allowance of 3510 mg of potassium per day. Median intake of salt was 8.8 g/day (IQR, 5.5–13.8) (according to urinary data). Conclusions: The findings from the present study showed considerable underestimation of dietary sodium and potassium intake based on self-reported dietary data. Urinary data revealed more accurate results, and showed that Latvian adults exceed the amount of salt recommended and consume less potassium than recommended. The pilot study also showed that the chosen methods are adequate for implementation in large, population-based studies to evaluate dietary intake of salt, sodium, and potassium in populations of Latvian adults.

Association between Hypouricemia and Reduced Kidney Function: A Cross-Sectional Population-Based Study in Japan

2015 ◽  
Vol 41 (2) ◽  
pp. 138-146 ◽  
Author(s):  
Minako Wakasugi ◽  
Junichiro James Kazama ◽  
Ichiei Narita ◽  
Tsuneo Konta ◽  
Shouichi Fujimoto ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Kidney Function ◽  
Serum Uric Acid Level ◽  
Kidney Injury ◽  
Population Based ◽  
Guidance System ◽  
Sensitivity Analyses ◽  
Cross Sectional ◽  
Reduced Kidney Function

Background: Hypouricemia, conventionally defined as a serum uric acid level of ≤2 mg/dl, is considered a biochemical disorder with no clinical significance. However, individuals with renal hypouricemia have a high risk of urolithiasis and exercise-induced acute kidney injury, both of which are risk factors for reduced kidney function. Methods: To test the hypothesis that individuals with hypouricemia would be at a higher risk of reduced kidney function, we conducted a population-based cross-sectional study using data from the Specific Health Checkups and Guidance System in Japan. Logistic analysis was used to examine the relationship between hypouricemia and reduced kidney function, defined as estimated glomerular filtration rate <60 ml/min/1.73 m2. Results: Among 90,710 men (mean age, 63.8 years) and 136,935 women (63.7 years), 193 (0.2%) and 540 (0.4%) were identified as having hypouricemia, respectively. The prevalence of hypouricemia decreased with age in women (p for trend <0.001), but not in men (p for trend = 0.24). Hypouricemia was associated with reduced kidney function in men (odds ratio, 1.83; 95% confidence interval, 1.23-2.74), but not in women (0.61; 0.43-0.86), relative to the reference category (i.e., serum uric acid levels of 4.1-5.0 mg/dl) after adjusting for age, drinking, smoking, diabetes, hypertension, hypercholesterolemia, obesity, and history of renal failure. Sensitivity analyses stratified by diabetic status yielded similar results. Conclusions: This study is the first to provide evidence that hypouricemia is associated with reduced kidney function in men. Further research will be needed to determine the long-term prognosis of individuals with hypouricemia.

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