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Clinical Nutrition

High sodium intake is associated with important risk factors in a large cohort of chronic kidney disease patients

European Journal of Clinical Nutrition volume 69, pages 786–790 (2015)Cite this article

Subjects

Abstract

Background/objectives:

An increased risk of mortality and cardiovascular disease (CVD) is observed in people with chronic kidney disease (CKD) even in early stages. Dietary sodium intake has been associated with important CVD and CKD progression risk factors such as hypertension and proteinuria in this population. We aimed to investigate the relationship between sodium intake and CVD or CKD progression risk factors in a large cohort of patients with CKD stage 3 recruited from primary care.

Subjects/methods:

A total of 1733 patients with previous estimated glomerular filtration rate (eGFR) of 30–59 ml/min/1.73m2, with a mean age 72.9±9.0 years, were recruited from 32 general practices in primary care in England. Medical history was obtained and participants underwent clinical assessment, urine and serum biochemistry testing. Sodium intake was estimated from three early-morning urine specimens using an equation validated for this study population.

Results:

Sixty percent of participants who had estimated sodium intake above recommendation (>100 mmol/day or 6 g salt/day) also had higher diastolic blood pressure, mean arterial pressure (MAP), urinary albumin-to-creatinine ratio, high-sensitive C-reactive protein and uric acid and used a greater number of anti-hypertensive drugs. In multivariable regression analysis, excessive sodium intake was an independent predictor of MAP (B=1.57, 95% confidence interval (CI) 0.41–2.72; P=0.008) and albuminuria (B=1.35, 95% CI 1.02–1.79; P=0.03).

Conclusions:

High sodium intake was associated with CVD and CKD progression risk factors in patients with predominantly early stages of CKD followed up in primary care. This suggests that dietary sodium intake could afffect CVD risk even in early or mild CKD. Intervention studies are warranted to investigate the potential benefit of dietary advice to reduce sodium intake in this population.

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Acknowledgements

This study was supported by a fellowship a grants from Kidney Research UK and British Renal Society (awarded to NJM) and the CAPES Foundation - Ministry of Education of Brazil (awarded to FN), as well as an unrestricted educational grant from Roche Products plc. This collaboration was facilitated by the Sister Renal Centers Program of the International Society of Nephrology.

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Authors and Affiliations

  1. School of Medicine, Pontificia Universidade Católica do Paraná, Curitiba, Brazil

    F B Nerbass & R Pecoits-Filho

  2. Nephrology Division, Nutrition Department, Pro-rim Foundation, Joinville, Brazil

    F B Nerbass

  3. Department of Renal Medicine, Royal Derby Hospital, Derbyshire, UK

    N J McIntyre, C W McIntyre & M W Taal

  4. Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK,

    C W McIntyre

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  1. F B Nerbass
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Correspondence to F B Nerbass.

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Nerbass, F., Pecoits-Filho, R., McIntyre, N. et al. High sodium intake is associated with important risk factors in a large cohort of chronic kidney disease patients. Eur J Clin Nutr 69, 786–790 (2015). https://doi.org/10.1038/ejcn.2014.215

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