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Abstract: PO2257

Urinary Sodium-to-Potassium Excretion Ratio Is Associated with Incident CKD in the General Population

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Joo, Young Su, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Jhee, Jong Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Park, Jung Tak, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
Background

Previous study suggests that urinary sodium to potassium (UNAK) ratio is associated with cardiovascular event and mortality, but the association of incident chronic kidney disease (CKD) and UNAK ratio in a preserved kidney function adult showed conflict results.

Methods

Data from the Korean Genome and Epidemiology, a prospective community-based cohort study were used to evaluate the between UNAK ratio and CKD development. 24 hour estimated sodium and potassium excretion amounts were calculated by a Kawasaki equation using spot urinary potassium and sodium measurements. A total 4088 participants were analyzed with a primary outcome of incident CKD that defined as estimated glomerular filtration ratio (eGFR) <60 mL/min/1.73m2 in ≥2 consecutive measurements during the follow-up period.

Results

The mean age was 52.1 ± 88 years and 47.5% were male. The median estimated 24h urinary sodium excretion, potassium excretion, UNAK ratio were 4.9 (4.1-5.8) g/day, 2.1 (1.8-2.5) g/day, and 2.3 (1.9-2.7), respectively. During 37,950 person-year of follow-up (median 11.5 years), the primary outcome developed in 513 participants and corresponding incidence rate was 14.0 (95% Confidence interval [CI], 12.9 to 15.3) per 1000 person-year. When the participants were categorized into quartiles according to UNAK ratio, age, sex and baseline eGFR adjusted hazard ratios (HR) (95% CI) for the Cox proportional hazard model were 0.76 (0.59-0.96), 0.89 (0.70-1.14), and 1.15 (0.91-1.46) from UNAK ratio quartile 1, 2, and 3, respectively as compared with the highest quartile and this finding was consistent even after further adjustment. Similar results were observed when log-transformed UNAK ratio was treated as a continuous variable; for one increase in UNAK ratio, there was a 51% higher risk of adverse kidney outcome (HR 1.51, 1.12-2.04). Spline regression analysis show that HR increased more steeply up to 1 in log transformed UNAK ratio, but there was no significant increase of risk after that.

Conclusion

low UNAK ratio is significantly associated with a decreased risk of CKD development.