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Abstract: FR-PO206

Effect of Dietary Salt Intake on Renal Outcomes in Advanced CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kang, Minjung, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ryu, Hyunjin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

The present study analyzed the effect of dietary salt intake on renal outcome for Asian CKD patients. The study is conducted on large number of CKD patients at stages G3a, G3b and G4, with long term follow-up. This study suggests the optimal amount of salt intake for advanced CKD patients.

Methods

Our data were extracted from The KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD). A total of 1,409 CKD patients at stages G3a, G3b and G4, who were enrolled in the KNOW-CKD from 2011 to 2016 were included in the analysis. After excluding 413 patients with incomplete data to define 24-hour urine sodium excretion, 996 non-dialysis CKD patients were finally analyzed. Dietary salt intake, assessed by 24-hour urine sodium excretion, was divided into quartile groups. Second quartile (Q2, 6.72 ~9.14 g salt/day) was regarded as the reference group. Estimated glomerular filtration rate (eGFR) was assessed by CKD-EPI (Cr) equation based on isotope dilution mass spectrometry (IDMS)-traceable creatinine measured at a central laboratory. eGFR slope was analyzed by mixed model from the subjects who repeatedly measured the serum creatinine level more than 4 times at 6- to 12-month interval. Composite renal event is defined either as eGFR halving or as initiation of renal replacement therapy (RRT). Each component of composite renal event was also analyzed.

Results

During the mean 45.6 months of follow-up, 225 subjects developed the composite renal event. After adjustment for confounders including baseline eGFR, multiple Cox regression showed that the risk of composite renal outcomes is significantly higher in the highest quartile group (Q4, salt intake > 11.89 g/day, HR 1.86, p<0.024). Multiple linear regression showed that eGFR slope was not independently associated with daily salt intake (b=-0.02, P=0.23).

Conclusion

High salt intake, assessed by 24 hour urine sodium excretion, is associated with increased risk of CKD progression in advanced CKD.