期刊论文详细信息
BMC Nephrology
Estimation of salt intake from spot urine samples in patients with chronic kidney disease
Tatsuo Hosoya1  Hiroyuki Terawaki1  Akihiko Hamaguchi1  Masatsugu Nakao1  Koki Takane1  Ai Kimura1  Makoto Ogura1 
[1] Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18, Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
关键词: Urinary sodium excretion;    Salt intake;    Chronic kidney disease;   
Others  :  1083177
DOI  :  10.1186/1471-2369-13-36
 received in 2011-08-21, accepted in 2012-05-21,  发布年份 2012
PDF
【 摘 要 】

Background

High salt intake in patients with chronic kidney disease (CKD) may cause high blood pressure and increased albuminuria. Although, the estimation of salt intake is essential, there are no easy methods to estimate real salt intake.

Methods

Salt intake was assessed by determining urinary sodium excretion from the collected urine samples. Estimation of salt intake by spot urine was calculated by Tanaka’s formula. The correlation between estimated and measured sodium excretion was evaluated by Pearson´s correlation coefficients. Performance of equation was estimated by median bias, interquartile range (IQR), proportion of estimates within 30% deviation of measured sodium excretion (P30) and root mean square error (RMSE).The sensitivity and specificity of estimated against measured sodium excretion were separately assessed by receiver-operating characteristic (ROC) curves.

Results

A total of 334 urine samples from 96 patients were examined. Mean age was 58 ± 16 years, and estimated glomerular filtration rate (eGFR) was 53 ± 27 mL/min. Among these patients, 35 had CKD stage 1 or 2, 39 had stage 3, and 22 had stage 4 or 5. Estimated sodium excretion significantly correlated with measured sodium excretion (R = 0.52, P < 0.01). There was apparent correlation in patients with eGFR <30 mL/min (R = 0.60, P < 0.01). Moreover, IQR was lower and P30 was higher in patients with eGFR < 30 mL/min. Estimated sodium excretion had high accuracy to predict measured sodium excretion, especially when the cut-off point was >170 mEq/day (AUC 0.835).

Conclusions

The present study demonstrated that spot urine can be used to estimate sodium excretion, especially in patients with low eGFR.

【 授权许可】

   
2012 Ogura et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150101011441628.pdf 423KB PDF download
Figure 5. 33KB Image download
Figure 4. 37KB Image download
Figure 3. 39KB Image download
Figure 2. 36KB Image download
Figure 1. 28KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】
  • [1]Weir MR, Fink JC: Salt Intake and Progression of Chronic Kidney Disease: An Overlooked Modifiable Exposure? A Commentary. Am J Kid Dis 2005, 45:176-188.
  • [2]Jones-Burton C, Mishra SI, Fink JC, Brown J, Gossa W, Bakris GL, Weir MR: An in-depth review of the evidence linking dietary salt intake and progression of chronic kidney disease. Am J Nephrol 2006, 26:268-275.
  • [3]Bakris GL, Smith A: Effects of sodium intake on albumin excretion in patients with diabetic nephropathy treated with long-acting calcium antagonists. Ann Intern Med 1996, 125:201-204.
  • [4]Heeg JE, de Jong PE, van der Hem GK, de Zeeuw D: Efficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril. Kidney Int 1989, 36:272-279.
  • [5]Imanishi M, Yoshioka K, Okumura M, Konishi Y, Okada N, Morikawa T, Sato T, Tanaka S, Fujii S: Sodium sensitivity related to albuminuria appearing before hypertension in type 2 diabetic patients. Diabetes Care 2001, 24:111-116.
  • [6]Parmer RJ, Stone RA, Cervenka JH: Renal hemodynamics in essential hypertension. Racial differences in response to changes in dietary sodium. Hypertension 1994, 24:752-757.
  • [7]Schiffl H, Kuchle C, Lang S: Dietary salt, intracellular ion homeostasis and hypertension secondary to early-stage kidney disease. Miner Electrolyte Metab 1996, 22:178-181.
  • [8]Cianciaruso B, Bellizzi V, Minutolo R, Colucci G, Bisesti V, Russo D, Conte G, De Nicola L: Renal adaptation to dietary sodium restriction in moderate renal failure resulting from chronic glomerular disease. J Am Soc Nephrol 1996, 7:306-313.
  • [9]Cianciaruso B, Bellizzi V, Minutolo R, Tavera A, Capuano A, Conte G, De Nicola L: Salt intake and renal outcome in patients with progressive renal disease. Miner Electrolyte Metab 1998, 24:296-301.
  • [10]Kuriyama S, Tomonari H, Ohtsuka Y, Yamagishi H, Ohkido I, Hosoya T: Salt intake and the progression of chronic renal diseases (in Japanese). Nippon Jinzo Gakkai Shi 2003, 45:751-758.
  • [11]Intersalt Cooperative Research Group: INTERSALT: an international study of electrolyte excretion and blood pressure: results for 24 h urinary sodium and potassium excretion. Br Med J 1988, 297:319-328.
  • [12]Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H, Hashimoto T: A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens 2002, 16:97-103.
  • [13]Kamata K, Tochikubo O: Estimation of 24 h urinary sodium excretion using lean body mass and overnight urine collected by a pipe-sampling method. J Hypertens 2002, 20:2191-2197.
  • [14]Kawasaki T, Itoh K, Uezono K, Sasaki H: A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol 1993, 20:7-14.
  • [15]Kawasaki T, Uezono K, Ueno M, Kikkawa K, Komuro T, Nakamuta S, Kawazoe N, Muratani H, Omae T: Studies of urinary creatinine excretion in clinically healthy subjects (1) Influence of age, sex, exercise and amount of salt intake on urinary creatinine excretion and its circadian rhythm. J Health Sci 1984, 6:1-8.
  • [16]Kawano Y, Kawasaki T, Kawazoe N, Abe I, Uezono K, Ueno M, Fukiyama K, Omae T: Circadian variations of urinary dopamine, norepinephrine, epinephrine and sodium in normotensive and hypertensive subjects. Nephron 1990, 55:277-282.
  • [17]Staessen J, Broughton PM, Fletcher AE, Markowe HL, Marmot MG, Rose G, Semmence A, Shipley MJ, Bulpitt CJ: The assessment of the relationship between blood pressure and sodium intake using whole-day, daytime and overnight urine collections. J Hypertens 1991, 9:1035-1040.
  • [18]Kawasaki T, Nakamuta S, Fukiyama K, Omae T: Determination of urinary excretions of aldosterone and sodium by short-term collections of urine in healthy men. Jpn Circ J 1978, 43:621-626.
  • [19]Kawasaki T, Uezono K, Utsunomiya H, Imamura K, Kikkawa K, Ueno M, Fujishima M: Studies on estimation of 24-hour urinary sodium excretion from predicted creatinine excretion and fractional urine sodium/creatinine ratio. J Health Sci 1986, 8:57-63.
  • [20]Mann SJ, Gerber LM: Estimation of 24-hour sodium excretion from spot urine samples. J Clin Hypertens 2010, 12:174-180.
  • [21]Fukuda M, Munemura M, Usami T, Nakao N, Takeuchi O, Kamiya Y, Yoshida A, Kimura G: Nocturnal blood pressure is elevated with natriuresis and proteinuria as renal function deteriorates in nephropathy. Kidney Int 2004, 65:621-625.
  • [22]WHO Regional Office for Europe: Nutrition, Food Security Programme. Food based dietary guidelines in the WHO European region. Copenhagen: Denmark; 2003.
  • [23]Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, Winston MC, Karimbakas J, National High Blood Pressure Education Program Coordinating Committee: Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA 2002, 288:1882-1888.
  • [24]Swift PA, Markandu ND, Sagnella GA, He FJ, MacGregor GA: Modest salt reduction reduces blood pressure and urine protein excretion in black hypertensives A randomized control trial. Hypertension 2005, 46:308-312.
  文献评价指标  
  下载次数:125次 浏览次数:29次