Kidney Week

Abstract: SA-PO0878

Dietary Sodium-Potassium Ratio and Kidney Function in the Adult US Population: A Comparison of Pre- and Post-COVID-19 NHANES Data

Session Information

• Health Maintenance, Nutrition, and Metabolism
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Urhoghide, Eseosa Omosivie, Authority Health, Detroit, Michigan, United States

Eseosa Omosivie Urhoghide, MD

• Edobor, Edeoba, NC State University, Raleigh, North Carolina, United States

Edeoba Edobor, PhD

Background

The association of dietary sodium and potassium intake with kidney function has been a subject of interest.^. While some studies have implicated dietary sodium in kidney dysfunction through its effect on elevated blood pressure, and vascular alteration, among other pathways, others have reported negative or no association between dietary potassium and risk of kidney diseases. Moreover, there is empirical and anecdotal evidence that the COVID-19 pandemic resulted in significant changes in dietary patterns, nutrient intake, and lifestyle, which could affect the overall quality of diet at the population level. This study examined the association between dietary sodium–potassium (Na/K) ratio and indicators of kidney function among U.S. adults and assessed whether these associations differed between pre- and post-COVID-19 pandemic populations.

Methods

We analyzed cross-sectional data from adult participants (≥20 years) in the 2017–2020 (pre-pandemic) and 2021–2023 (post-pandemic) National Health and Nutrition Examination Surveys. Dietary Na/K ratio was calculated from 24-hour dietary recall. Kidney function indicators included estimated glomerular filtration rate (eGFR), urinary albumin–creatinine ratio (UACR), albuminuria, and chronic kidney disease (CKD) risk categories defined by KDIGO guidelines. We employed linear, logistic, and multinomial logistic regression models adjusting for demographic, lifestyle, and clinical covariates. Survey weights were applied to ensure national representativeness.

Results

The sample included 9,912 adults (6,046 pre-pandemic; 3,866 post-pandemic). In the full sample, a higher dietary Na/K ratio was associated with lower eGFR (β = −0.88 mL/min/1.73 m² ; p = 0.02). This association was significant in the post-pandemic sample (β = −1.31; p = 0.03) but not in the pre-pandemic sample. Na/K ratio was not associated with UACR or albuminuria. However, a higher Na/K ratio was associated with increased relative risk of being in high-risk and very high-risk CKD categories, particularly in the post-pandemic sample.

Conclusion

A higher dietary Na/K ratio was associated with poorer kidney function and greater CKD risk among U.S. adults, with stronger associations observed post-pandemic. These findings highlight the importance of Na/K balance in dietary guidance, particularly in the post-COVID-19 context.