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Abstract: TH-PO0311

Association Between Estimated Sodium and Potassium Intake and All-Cause Mortality or Cardiovascular Disease in Patients with CKD: Fukuoka Kidney Disease Registry Study

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Suenaga, Tatsuya, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Tanaka, Shigeru, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Kitamura, Hiromasa, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Okamura, Kazuhiro, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Yamada, Shunsuke, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Tsuruya, Kazuhiko, Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan
  • Ago, Tetsuro, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
  • Nakano, Toshiaki, Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Fukuoka, Japan
Background

In the general population, higher sodium intake, lower potassium intake, and a higher sodium-to-potassium intake ratio are associated with increased risks of mortality and cardiovascular disease (CVD). However, these associations have not been thoroughly investigated in patients with chronic kidney disease (CKD), and the sodium-to-potassium intake ratio has not been reported in this population.

Methods

A total of 4,314 Japanese non-dialysis CKD patients aged 18 years or older from the Fukuoka Kidney disease Registry (FKR) Study were prospectively followed for 5 years. Patients were categorized into quartiles (Q1–Q4) based on estimated sodium intake, potassium intake, and the sodium-to-potassium intake ratio, as assessed using the Tanaka formula from spot urine samples. The associations between each quartile and the all-cause mortality or CVD (including myocardial infarction, angina pectoris, heart failure, peripheral arterial disease, and stroke) were analyzed using Cox proportional hazards models, adjusted for potential confounders.

Results

During the follow-up period, 687 patients developed all-cause mortality or CVD. Patients in the highest quartile (Q4) of sodium intake and sodium-to-potassium intake ratio had significantly higher hazard ratios (HRs) for all-cause mortality or CVD compared to those in the lowest quartile (Q1), based on fully multivariable-adjusted Cox models (HR [95% confidence interval, CI]: sodium intake, 1.53 [1.19–1.97]; sodium-to-potassium intake ratio, 1.40 [1.11–1.75]). Conversely, patients in the lowest quartile (Q1) of potassium intake had significantly higher HRs than those in Q4 (HR [95% CI]: 1.42 [1.06–1.92]).

Conclusion

Higher sodium intake, lower potassium intake, and a higher sodium-to-potassium intake ratio were associated with an increased risk of all-cause mortality or CVD in patients with CKD.

Digital Object Identifier (DOI)